DR. JACALYN DICELLO (NPI# 1518989656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518989656 |
| Entity Type | Individual |
| Full Name | DR. JACALYN DICELLO |
| Credential | M.D. |
| Practice Address |
14000 Nicollet Ave Suite 100 Burnsville MN 55337-5790 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 9524280200 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
23731 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE SHIELD | 57F36DI | 01 |
| MN | HEALTH PARTNERS | HP10327 | 01 |
| MN | PREFERRED ONE | 0371001 | 01 |
| MN | 087288100 | 05 | |
| MN | MEDICA | 0702123 | 01 |
| Street Address |
14000 NICOLLET AVE SUITE 100 |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55337-5790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407848658 | Steven L Johnson | Family Medicine | 14000 Nicollet Ave, Ste 100, Burnsville, MN 55337-5790 | 2005-08-15 |
| 1356955819 | Erin K. Allen, D.d.s., Pllc | Clinic/Center | 14000 Nicollet Ave, Ste 302, Burnsville, MN 55337-5784 | 2020-09-02 |
| 1386089993 | Neil Gordon Johnson | Family Medicine | 14000 Nicollet Ave, Suite 100, Burnsville, MN 55337-5790 | 2013-05-09 |
| 1477886687 | Jared Lee Schroeder | Physical Therapist | 14000 Nicollet Ave, Suite 200, Burnsville, MN 55337-5790 | 2009-09-08 |
| 1689857955 | Kim D Fjelstad Dpm Pa | Podiatrist | 14000 Nicollet Ave, 306, Burnsville, MN 55337-5790 | 2007-12-10 |
| 1437345055 | Tracy M Luchsinger | Physician Assistant | 14000 Nicollet Ave, Suite 100, Burnsville, MN 55337-5790 | 2007-09-18 |
| 1063613131 | Tiffany T Waki | Dentist | 14000 Nicollet Ave, Suite 300, Burnsville, MN 55337-5790 | 2007-05-29 |
| 1619025798 | Kuipers Orthodontics | Dentist | 14000 Nicollet Ave, Suite 300, Burnsville, MN 55337-5790 | 2007-01-08 |
| 1144386392 | Michael John Ebertz | Dermatology | 14000 Nicollet Ave, Suite 304, Burnsville, MN 55337-5790 | 2006-12-29 |
| 1790841989 | Heidi Leigh Foster | Dermatology | 14000 Nicollet Ave, Suite 304, Burnsville, MN 55337-5790 | 2006-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939397 | Alpha Quality Care1 L. L. C. | Home Infusion | 12924 18th Ave South, Burnsville, MN 55337 | 2020-07-13 |
| 1568085900 | Kathryn Harris | Counselor | 11939 W. River Hills Dr., Burnsville, MN 55337 | 2020-05-20 |
| 1952941254 | Noah Home Care Inc. | Home Health | 13521 Nicollet Lane, Burnsville, MN 55337 | 2020-01-14 |
| 1750854287 | Baraka Home Care LLC | Nursing Care | 1700 James Place, Burnsville, MN 55337 | 2019-01-08 |
| 1699298778 | Raphael Cheron-dittmann | Hearing Instrument Specialist | 14000 Nicollet Ave. S., Suite 303, Burnsville, MN 55337 | 2017-07-20 |
| 1669909818 | Mercy Home Care Ltd | Hospice Care, Community Based | 1020 E 146th St Ste 220d, Burnsville, MN 55337 | 2017-05-18 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
| 1740657204 | Mercy Link, LLC | Home Health | 13005 Salem Pl, Burnsville, MN 55337 | 2015-08-31 |
| 1669852158 | Mixa Dipak Patel | Physical Therapy Assistant | 8380 Hiawatha Ave, Eden Prairie, MN 55337 | 2015-06-01 |
| Find all providers in zip 55337 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609028521 | William Meyer | Obstetrics & Gynecology | 6517 Cherokee Trl, Edina, MN 55439-1108 | 2008-10-22 |
| 1083658181 | Kimberly Anne Gerten | Obstetrics & Gynecology | 6565 France Ave S Ste 200, Edina, MN 55435-2141 | 2006-06-16 |
| 1568401313 | Jerald W Reinhardt | Obstetrics & Gynecology | 1428 Central Ave Ne, East Grand Forks, MN 56721-1605 | 2006-06-06 |
| 1255339883 | Kenneth M Palmer | Obstetrics & Gynecology | 1650 4th St Se, Rochester, MN 55904-4717 | 2005-07-08 |
| 1740286400 | Susan Joyce Cushman | Obstetrics & Gynecology | 14001 Ridgedale Dr, Ste 200, Minnetonka, MN 55305-1753 | 2005-06-27 |
| 1114333754 | Fairview Health Services | Obstetrics & Gynecology | 7450 France Ave S, Suite 240, Edina, MN 55435-4792 | 2014-07-03 |
| 1457648065 | Marie C Nelson | Obstetrics & Gynecology | 811 2nd St Se, Little Falls, MN 56345-3559 | 2011-07-03 |
| 1770878928 | Jill A Moes | Obstetrics & Gynecology | 200 1st St Sw, Rochester, MN 55905-0001 | 2011-06-16 |
| 1427366814 | Leigh F Bauer | Obstetrics & Gynecology | 320 E Main St, Ob/gyn Dept, Crosby, MN 56441-1645 | 2010-09-20 |
| 1649398546 | Women's Health & Laser Aesthetic Center, LLC | Obstetrics & Gynecology | 7250 France Ave S, Suite 102, Edina, MN 55435-4305 | 2007-03-27 |
| Find all providers with the same taxonomy | ||||
| City | BURNSVILLE |
| Zip Code | 55337 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.