Individual provider Active NPI

Nathan Michael Wick, DO

  • Anesthesiology Physician
  • Plymouth, MN
National Provider Identifier
1992366504
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
73518 Issued in MN
Practice address
14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876
Phone
(763) 559-3779
NPI assigned
Jun 25, 2019
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 73518 MN Primary
Pain Medicine Physician 208VP0000X 73518 MN

Addresses

Primary practice location

14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876

Mailing address

PO Box 47159
Plymouth, MN 55447-0159
Phone (763) 559-3779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230515002509 MN Practitioner - Pain Management 7113253683 Reassigns benefits to 2 organizations
I20250819002492 MN Practitioner - Anesthesiology 7113253683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology, P.a.Group PAC ID 9335033034, 136 clinicians
Interventional Spine and Pain Physicians PAGroup PAC ID 2466606264, 42 clinicians

Practice addresses (Care Compare)

3300 N Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5370

9645 Grove Cir N
Suite 200
Maple Grove, MN 55369-2684
Phone (763) 201-8191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73518MNMDOphthalmic Technician/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology, P.a. Anesthesiology CurrentSince Jul 14, 2025 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2023 Accepting new patients
Anesthesia Associates, PLLC CurrentSince Aug 1, 2024 Accepting new patients
Interventional Spine and Pain Physicians, PA CurrentSince Aug 1, 2024 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2023 Accepting new patients
Mayo Clinic Current Accepting new patients
Metropolitan Surgical Center, LLC Past Accepting new patients

Locations

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

7700 France Ave S
Ste 260
Edina, MN 55435

9600 Upland Ln N
Ste 160
Maple Grove, MN 55369

9645 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 300-2193

9645 Grove Cir N
Ste 250
Maple Grove, MN 55369

9855 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-5800

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1992366504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47159",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554470159",
            "telephone_number": "763-559-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 28TH AVE N STE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474876",
            "telephone_number": "763-559-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "NATHAN",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "73518",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MN",
            "license": "73518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.