MR. BRIAN DAVID ZELICKSON (M.D.) – Dermatology Physician, NPI 1336195148

MR. BRIAN DAVID ZELICKSON (M.D.) is a healthcare provider. based in Minneapolis, Minnesota. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. 31389 (MN). The NPI Number for MR. BRIAN DAVID ZELICKSON (M.D.) is 1336195148

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
MR. BRIAN DAVID ZELICKSON (M.D.)
NPI
1336195148
Phone
(612) 338-0711
Address
825 NICOLLET MALL
Enumeration Date
25 May 2006
Last Update Date
1 July 2010

Doctor Profile

Medical School Name
MAYO MEDICAL SCHOOL
Secondary Phone
9529298888
Graduation Year
1986 (40 years ago)
PAC ID
9638186729
Group Practice PAC ID
0446558993
Professional Enrollment ID
I20071117000105
Address ID
MN554241200ED4100XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

419 DERMATOLOGY in MN

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Provider Addresses for MR. BRIAN DAVID ZELICKSON (M.D.)

  • Nicollet Mall, South 5th Street, Minneapolis, Hennepin County, Minnesota, 55415, United States

    SUITE 1002

    MINNEAPOLIS, MN 554022606

    Phone: (612) 338-0711

    Fax: (612) 332-3663

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $164.

Total Amount is formed as General ($164) + Research ($0) + Ownership ($0) = $164.

Last reported payment date: 2024-08-19 • Largest payer in this snapshot: REVANCE THERAPEUTICS, INC. ($86).

Total Amount

$164

General + Research + Ownership

Payments

6

Total payment records

General Amount

$164

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-11-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20071117000105IDermatologyMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths1,081171$0
99213Established patient office or other outpatient visit, 20-29 minutes302228$0
17000Destruction of precancer skin growth, 1 growth296225$0
88305Pathology examination of tissue using a microscope, intermediate complexity261164$0
17110Destruction of skin growth, 1-14 growths162140$0
View full utilization report →

Insurance plans in this area (ZIP 55402)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446558993View full group profile
NameSpecialtyState
Physician AssistantCO
D E R M A T O L O G YWI
Nurse PractitionerMN
Physician AssistantMN
Dermatology, Internal MedicineMN
Physician AssistantMN
Nurse PractitionerMN
Micrographic Dermatologic Surgery (Mds), DermatologyMA
D E R M A T O L O G YMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

Does MR. BRIAN DAVID ZELICKSON (M.D.) have a public NPI I can cite?
Public records show MR. BRIAN DAVID ZELICKSON (M.D.) under NPI 1336195148.
Is MR. BRIAN DAVID ZELICKSON (M.D.) currently accepting referrals based on NPI status?
Registry metadata lists MR. BRIAN DAVID ZELICKSON (M.D.) as active.
How should patients interpret MR. BRIAN DAVID ZELICKSON (M.D.)'s specialty?
The extract shows Dermatology Physician for MR. BRIAN DAVID ZELICKSON (M.D.). Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. BRIAN DAVID ZELICKSON (M.D.)?
MR. BRIAN DAVID ZELICKSON (M.D.) is associated with Minneapolis, Minnesota in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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