Individual provider Active NPI

Deidra Sieck, MD

  • Family Medicine Physician
  • Saint Cloud, MN
National Provider Identifier
1952097453
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
81093 Issued in MN
Practice address
1555 Northway Dr Ste 200
Saint Cloud, MN 56303-4913
Phone
(320) 240-3157
Fax
(320) 240-3165
NPI assigned
Apr 17, 2023
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 81093 MN Primary

Addresses

Primary practice location

1555 Northway Dr Ste 200
Saint Cloud, MN 56303-4913

Mailing address

1555 Northway Dr Ste 200
Saint Cloud, MN 56303-4913
Phone (320) 240-3157

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719004010 MN Order and Referring Only - Family PracticePractitioner - Family Practice 3678933876

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556

1406 6TH Ave N
Saint Cloud, MN 56303-1900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81093MNMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: dsieck681280@direct.centracare.com

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1952097453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NORTHWAY DR STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034913",
            "telephone_number": "320-240-3157",
            "fax_number": "320-240-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 NORTHWAY DR STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034913",
            "telephone_number": "320-240-3157",
            "fax_number": "320-240-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIECK",
        "first_name": "DEIDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "81093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.