Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacklyn Mae Ellickson, MD

Individual provider Endocrinology, Diabetes & Metabolism Physician · NPI 1538395496

Jacklyn Mae Ellickson, MD is an Endocrinology in Saint Paul, Minnesota. Graduated from University of Wisconsin School of Medicine in 2008, 18 years ago. Practices with Group Health Plan Inc, a 1,633-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota and Wisconsin.

Years since qualifying
18
Trained at
University of Wisconsin School of Medicine
Licensed in
MN, WI
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone: (651) 254-7870
Fax: (651) 254-7876
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endocrinology, Diabetes & Metabolism Physician (primary) Taxonomy 207RE0101X · Licence 53921 (MN)
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X · Licence 62721-20 (WI)

Record details

NPI number1538395496
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 5, 2009
Last updated in NPPESMarch 17, 2022
Certification dateMarch 17, 2022
Mailing address8170 33rd Ave S, Ms 21110q, Bloomington, MN 55425-4516

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyENDOCRINOLOGY
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2008 (18 years in practice)
Group practice Group Health Plan Inc — 1633 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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