Nicole Evans Groeschl, MD
Individual provider Active NPI Family Medicine Physician · Pine Island, MN
NPI 1770840985 · NPPES record last updated Feb 1, 2017
Key facts
- NPI
- 1770840985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 59401 (MN)
- Practice address
- 111 County Road 11 NW
Pine Island, MN 55963-9756 - Phone
- (507) 356-4929
- NPI assigned
- Apr 12, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical College of Wisconsin, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Polinsky Medical Rehabilitation Center
The Duluth Clinic LTD
Practice addresses (Care Compare)
1600 Miller Trunk Hwy
BLDG C
Duluth, MN 55811-5640
Phone (218) 786-5360
4212 Grand Ave
Duluth, MN 55807-2737
Phone (218) 786-3500
Hospital & facility affiliations
- Centerwell Home Health
- Essentia Health Duluth
- St Marys Hospital Superior
- Essentia Health St Mary'S Medical Center
- Essentia Health Moose Lake
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150909000552 | MN | Practitioner - Family Practice | 0547576415 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic, LTD | Current |
Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Locations
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 59401 | MN | Yes |
Addresses
Primary practice location
111 County Road 11 NW
Pine Island, MN 55963-9756
Mailing address
111 County Road 11 NW
Pine Island, MN 55963-9756
Phone (507) 356-4929
Other providers in Pine Island, MN
- Ellen Lilla Counseling LLC
- Rachael Finstuen
- Penny Louise Flavin
- Matthew E Florek
- Good Grief Counseling LLC
- Katie Marie Hassan
- Independent School District 255
- Terry Tock Jones
- Olivia Kimble
- Cori Klassen
All providers in Pine Island, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.