Active NPI
Nicholas John Dickovich, PA-C
- Physician Assistant
- Rochester, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13785
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Aug 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 7687 | AZ | |
| Physician Assistant | 363A00000X | 13785 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ndickovich570855@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210827000716 | MN | Practitioner - Physician Assistant | 7911332721 | 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
- Mayo Clinic
Practice addresses (Care Compare)
1216 2ND St SW
Rochester, MN 55902-1906
Phone (507) 255-5123
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Hospital & facility affiliations
- Mayo Clinic Hospital Rochester
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13785 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Arizona | Current | Accepting new patients | |
| Mayo Clinic | Current | Accepting new patients | |
| Mayo Clinic Arizona | Current | Accepting new patients |
Locations
5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800
13400 E Shea Blvd
Scottsdale, AZ 85259
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
Organizations & group practices 7
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.
-
- Clinical Medical Laboratory
- Rochester, MN
- NPI 1083249577
-
- Community Based Hospice Care Agency
- Rochester, MN
- NPI 1164758868
-
- Durable Medical Equipment & Medical Supplies
- Rochester, MN
- NPI 1467622092
-
- Air Ambulance
- Rochester, MN
- NPI 1821326570
-
- Multi-Specialty Clinic/Center
- Scottsdale, AZ
- NPI 1558332494
-
- Durable Medical Equipment & Medical Supplies
- Phoenix, AZ
- NPI 1699520049
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1922653294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKOVICH",
"first_name": "NICHOLAS",
"middle_name": "JOHN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-05",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "7687",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "13785",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ndickovich570855@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "200 1st St SW",
"city": "Rochester",
"state": "MN",
"country_code": "US",
"postal_code": "559050001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.