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Michael Charles Lick

Physician Assistant β€’ Bloomington, MN

Active NPI 1023793932 Individual Practitioner Male Practitioner
Practice location in NPPES

4300 Market Pte Dr Ste 100
Bloomington, MN 554355435

Call 4574952767 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4300 Market Pte Dr Ste 100

Bloomington, MN 554355435

Telephone 4574952767

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Michael Lick has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Michael Lick as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Bloomington and Minnesota

128 active clinicians are listed under Physician Assistant with a practice address in Bloomington, MN (4,007 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Bloomington

24.2% of these 128 clinicians have the CMS telehealth indicator.

69.5% of these 128 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-01-13
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20250325002072

Enrollment State Jurisdiction

MN

PECOS Control ID

3971026535

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

40 listed
Dr. Mitchell Annis , MD

Emergency Medicine

NPI 1487344990

Doctor of Medicine (M.D.)

NPI 1174191050

Doctor of Medicine (M.D.)

Dr. Brian Bristol , DO

Emergency Medicine

NPI 1063142628

Doctor of Osteopathic Medicine (D.O.)

Dr. Richard Campbell , MD

Emergency Medicine

NPI 1659945525

Doctor of Medicine (M.D.)

Dr. Amy Cho , MD

Emergency Medicine

NPI 1750546164

Doctor of Medicine (M.D.)

Dr. Jacob Collins , DO

Emergency Medicine

NPI 1245850627

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location January 13, 2025

Registered at 4300 MARKET PTE DR STE 100, BLOOMINGTON, MN 554355435 (Tel: 4574952767)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 13, 2025

Physician Assistant

βœ…
NPI Profile Active June 19, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 19, 2023

Registered at 115 W 5TH ST # 2, DULUTH, MN 558062729 (Tel: 6127088024)

πŸ“
Business Mailing Address (Initial Record) June 19, 2023

Registered at 115 W 5TH ST # 2, DULUTH, MN 558062729 (Tel: 6127088024)

πŸ‘€
Provider Name / Credentials (Initial Record) June 19, 2023

Recorded as MICHAEL LICK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 19, 2023

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration June 19, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1023793932
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 19, 2023
Last Update: January 13, 2025
Sole Proprietor: Yes

Other Physician Assistants in Bloomington

All Physician Assistants in Bloomington

Mailing Address

115 W 5th St # 2

Duluth, MN 558062729

Phone: 6127088024

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.