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

Johnathan Cicchese, DPT

Individual provider Physical Therapist · NPI 1073980793

Johnathan Cicchese, DPT is a Physical Therapist in Private Practice in Maplewood, Minnesota. Qualified in 2015, 11 years ago. Practices with Fairview Express Care, a 1,964-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
11
Licensed in
MN
In the registry since
2015
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1747 Beam Ave Ste Number 100
Maplewood, MN 55109-1128
Phone: (651) 326-5569
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 10069 (MN)

Record details

NPI number1073980793
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 28, 2015
Last updated in NPPESAugust 28, 2015
Mailing address2029 Henry St N, North Saint Paul, MN 55109-4114

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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