NPIMap

Individual provider Active NPI

Cherilyn Wicks, MD

  • Family Medicine Physician
  • Eagan, MN
National Provider Identifier
1780858589
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51016 Issued in MN
Practice address
1110 Yankee Doodle Rd
Eagan, MN 55121-2092
Phone
(651) 454-3970
Fax
(651) 241-0059
NPI assigned
Apr 14, 2008
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51016 MN Primary

Addresses

Primary practice location

1110 Yankee Doodle Rd
Eagan, MN 55121-2092

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

580 Rice St
Bethesda Clinic
Saint Paul, MN 55103-2148
Phone (651) 227-6551

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cwicks574282@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090220000498 MN Practitioner - Family Practice 2365507670 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Key CorporationGroup PAC ID 9032009238, 53 clinicians
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

1394 Jackson St
Suite 201
Saint Paul, MN 55117-4630
Phone (612) 315-5866

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Clinics CurrentSince Nov 21, 2020 Accepting new patients
Fairview Bethesda Hospital CurrentSince Sep 1, 2020 Accepting new patients
Allina Health System CurrentSince Jan 3, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Sep 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Nov 21, 2020 Accepting new patients
Healtheast St. John's Hospital CurrentSince Sep 1, 2020 Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 1, 2020 Accepting new patients
Healtheast Care System CurrentSince Sep 1, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Healtheast Medical Research Institute Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Allina Health System CurrentSince Jan 3, 2022 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
NPI 1083910871 Family Medicine Past Accepting new patients
University of Minnesota Physicians Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1110 Yankee Doodle Rd
Saint Paul, MN 55121
Phone (651) 454-3970

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

580 Rice St
Saint Paul, MN 55103
Phone (651) 227-6551

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1780858589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 YANKEE DOODLE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212092",
            "telephone_number": "651-454-3970",
            "fax_number": "651-241-0059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 Rice St",
            "address_2": "Bethesda Clinic",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551032148",
            "country_code": "US",
            "telephone_number": "651-227-6551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKS",
        "first_name": "CHERILYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "51016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwicks574282@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1110 Yankee Doodle Rd",
            "city": "Eagan",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551212092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.