NPIMap

Organization Active NPI

Catalyst Medical Center PC

  • Otolaryngology Physician
  • Fargo, ND
National Provider Identifier
1043378268
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CATALYST MEDICAL CENTER PC
Practice address
1800 21St Ave S
Fargo, ND 58103
Phone
(701) 365-8700
Fax
(701) 365-8701
NPI assigned
Dec 4, 2006
Last updated
May 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Susan M Mathison, MDNPI 1952469165
Title
Owner
Phone
(701) 365-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

1800 21St Ave S
Fargo, ND 58103

Mailing address

1800 21St Ave S
Fargo, ND 58103
Phone (701) 365-8700

Other identifiers 2

IdentifierTypeStateIssuer
13515MedicaidND
C04026OtherMNMN MEDICARE PIN

Other names 1

  • SUSAN M MATHISON MD LTD Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050823000867 ND Part B Supplier - Clinic/Group Practice 5395776967 Receives reassigned benefits from 14 practitioners
Practice locations: Fargo, ND; Grand Forks, ND; Jamestown, ND

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D2162227Catalyst Medical Center PC1800 21St Ave S, Fargo, ND 58103Certificate of waiverFeb 18, 2027

National Provider Directory

National Provider Directory

Locations

1135 Washington Ave
Ste 100
Detroit Lakes, MN 56501
Phone (701) 365-8700

826 Summit Ave
#164
Detroit Lakes, MN 56501
Phone (701) 365-8700

1800 21st Ave S
Fargo, ND 58103
Phone (701) 365-8670

1800 21st Ave S
#M
Fargo, ND 58103
Phone (701) 365-8700

2401 S Washington St
Ste B
Grand Forks, ND 58201
Phone (701) 610-3673

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEBJBD

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241136000000",
    "number": "1043378268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 21ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-365-8700",
            "fax_number": "701-365-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 21ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-365-8700",
            "fax_number": "701-365-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATALYST MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2009-05-01",
        "status": "A",
        "authorized_official_last_name": "MATHISON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-365-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13515",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICARE PIN",
            "identifier": "C04026",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUSAN M MATHISON MD LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.