NPIMap

Individual provider Active NPI

Nicole Lillian Hatcher, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1861034563
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13684 Issued in MN
Practice address
915 E 1St St
Duluth, MN 55805-2107
Phone
(218) 249-5439
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7617 AZ
Physician Assistant 363A00000X 13684 MN Primary

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805-2107

Mailing address

1012 E 2ND St
Duluth, MN 55805-2200
Phone (218) 249-7860

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, MT3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210525000580 MN Practitioner - Physician Assistant 5799117180 Reassigns benefits to 1 organization
I20240524002864 WI Practitioner - Physician Assistant 5799117180 Reassigns benefits to 1 organization
I20260513001298 MT Practitioner - Physician Assistant 5799117180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
St Peters HealthGroup PAC ID 7911814926, 206 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3900

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

2550 E Broadway St
Helena, MT 59601-4905
Phone (406) 447-2828

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • St Peters Health Hospital, Helena, MT, CCN 270003
  • Aspirus Lake View Hospital Hospital, Two Harbors, MN, CCN 241308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7617AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Apr 30, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Apr 30, 2021 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Apr 10, 2024 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: nhatcher352096@direct.aspirus.org

Organizations & group practices 24

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

View all 24

Hospital & facility affiliations 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1861034563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052200",
            "telephone_number": "218-249-7860",
            "fax_number": "218-249-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCHER",
        "first_name": "NICOLE",
        "middle_name": "LILLIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7617",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "915 E 1st St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.