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

Mrs. Nicole Therese Manecke, PA

Individual provider Medical Physician Assistant · NPI 1821180712

Mrs. Nicole Therese Manecke, PA is a Physician Assistant in Baxter, Minnesota. Qualified in 2002, 24 years ago. Practices with Dermatology Professionals, PA, a 9-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
24
Licensed in
IL
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

13359 Isle Dr Ste 3
Baxter, MN 56425-2222
Phone: (218) 454-7546
Fax: (218) 454-3062
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 085-001851 (IL)

Record details

NPI number1821180712
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 28, 2006
Last updated in NPPESJuly 9, 2008

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Dermatology Professionals, Pa — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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