Elicia Faith Dembele, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12402 Issued in MN

Practice address

6905 York Ave S
Edina, MN 55435-2517

Phone

(651) 707-5536

NPI assigned

Feb 21, 2025

Last updated

Mar 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Elicia Faith Swanson Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Primary Care Minnesota PLLCGroup PAC ID 2163945460, 30 clinicians

Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minuteclinic Diagnostic of Minnesota, P.a.

  • Family Nurse Practitioner
  • Eagan, MN
  • NPI 1407227945
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care Minnesota PLLC

  • Family Nurse Practitioner
  • Eagan, MN
  • NPI 1104632801
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1669278453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8313 9TH ST N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 YORK AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352517",
            "telephone_number": "651-707-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMBELE",
        "first_name": "ELICIA",
        "middle_name": "FAITH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "12402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELICIA",
            "last_name": "SWANSON",
            "middle_name": "FAITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dennis Dejesus, MD
• Dawn Nichelle Delavallade, MD
• Luis Fernando Delima Jr., D.D.S., F.A.C.P.
• Theresa Anne Demarco, MD
• John J Demars, MDA
• Denise H. Bisanz, P.a.
• William Emmett Dennehy III, DO
• Kristina Dennen
• Thomas Perry Densinger, DC
• Dental Specialist of Minnesota, PLLC (The Dental Specialists Edina (PEDS))

• Family Nurse Practitioner in Edina, MN
• Providers in Edina, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.