MITCHELL DANIEL GULLICKSON MD
NPI 1689415903
Dermatology in Rochester, MN

Q: What is Mitchell Gullickson's NPI number?

The NPI number for Mitchell Gullickson is 1689415903. It was assigned to this individual provider in the NPPES registry on June 3, 2024.

Q: What is Mitchell Gullickson's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since June 03, 2024PECOS EnrolledAccepts Medicare Assignment

200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 31, 2025, Jun 3, 2024 (2 updates tracked since 2024).

On this page

About Mitchell Daniel Gullickson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITCHELL DANIEL GULLICKSON MD (NPI 1689415903) is an individual dermatology provider in Rochester, Minnesota, licensed in Minnesota (80448) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS, is affiliated with Mayo Clinic Hospital Rochester, and maintains a secondary practice location in Fargo.

NPPES Registry Identity

NPI1689415903

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameMITCHELL DANIEL GULLICKSONCredential: MD

Location Address200 1ST ST SWRochester, MN 55905-7927

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (507) 284-2511

Phone(507) 284-2511

Sole ProprietorNo

Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 2024

Enumeration DateJune 3, 2024

Last NPPES UpdateJuly 31, 20252 updates tracked since enumeration

NPPES CertifiedJuly 31, 2025

✔ NPI 1689415903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in MN · 80448

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

200 1ST ST SW, Rochester, MN 55905

Open in Google Maps ↗

Secondary Practice Location 1

Location 15225 23rd Ave SFargo, ND 58104-7927 · Phone (701) 234-5933

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mitchell Daniel Gullickson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820596513

PECOS Enrollment IDI20250812002113

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mayo Clinic Hospital Rochester

Acute Care Hospitals · Rochester, MN

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number240010

Location1216 Second Street SouthwestRochester, MN 55902 · Olmsted County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY LEASURE MD

Internal Medicine