DANA WICKERSHEIM (NP) – Gerontology Nurse Practitioner, NPI 1780065862

DANA WICKERSHEIM (NP) is a healthcare provider. based in Minneapolis, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. R2095660 (MN). The NPI Number for DANA WICKERSHEIM (NP) is 1780065862

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DANA WICKERSHEIM (NP)
NPI
1780065862
Phone
Not provided
Address
1 VETERANS DR
Enumeration Date
15 June 2015
Last Update Date
4 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9528412345
Graduation Year
2020 (6 years ago)
PAC ID
5597282277
Group Practice PAC ID
9830152495
Professional Enrollment ID
I20250506002614
Address ID
MN553374799BU14551RDXX301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:10State licenses:2Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for DANA WICKERSHEIM (NP)

  • 1 VETERANS DR

    MINNEAPOLIS, MN 554172309

    Phone:

    Type: Mailing

  • 683 BIELENBERG DR STE 103

    WOODBURY, MN 551251711

    Phone: (952) 841-2346

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-05-06

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
I20250506002614INurse PractitionerMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55417)

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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: 9830152495View full group profile
NameSpecialtyState
Pain Management, PsychiatryMN
Physician AssistantMN
Nurse PractitionerMN
Nurse PractitionerFL
Physical Medicine And Rehabilitation, Interventional Pain Management, Pain ManagementMN
Nurse PractitionerMN
-MN
Nurse PractitionerMN
Physical Medicine And Rehabilitation, Pain ManagementMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

What is the standard ID for DANA WICKERSHEIM (NP) in the U.S.?
In the U.S., DANA WICKERSHEIM (NP) is identified by NPI 1780065862.
Does the public listing show DANA WICKERSHEIM (NP) as active?
DANA WICKERSHEIM (NP)'s NPI record reflects an active status in NPPES.
How should patients interpret DANA WICKERSHEIM (NP)'s specialty?
The extract shows Gerontology Nurse Practitioner for DANA WICKERSHEIM (NP). Clinical services aligned with this taxonomy classification.
Is DANA WICKERSHEIM (NP) tied to Minneapolis, Minnesota?
If you are local to Minneapolis, Minnesota, DANA WICKERSHEIM (NP) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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