Samuel Odame Anim, MD
Individual provider Active NPI Pediatric Hematology & Oncology Physician · Fargo, ND
NPI 1053514844 · NPPES record last updated Aug 30, 2022
Key facts
- NPI
- 1053514844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Hematology & Oncology Physician 2080P0207X
- License
- 11958 (ND)
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-2000
- Fax
- (701) 234-2345
- NPI assigned
- Jun 8, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Hematology/Oncology
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University Hospitals Medical Group Inc
Practice addresses (Care Compare)
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000
Hospital & facility affiliations
- Uh Cleveland Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.19 of 100
- Quality
- 63.13
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.18
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ND, OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120803000467 | ND | Practitioner - Pediatric Medicine |
3779739917 | Reassigns benefits to 2 organizations |
| I20221004002017 | OH | Practitioner - Hematology/Oncology | 3779739917 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54658 | MN | MD | Pediatric Hematology & Oncology Physician |
| 4301087288 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Bismarck | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| University Hospitals Medical Group Inc | Pediatrics | Current |
Accepting new patients |
| Multicare Health System | Past | Accepting new patients | |
| University Hospitals Cleveland Medical Center | Past | Accepting new patients |
Locations
2603 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5222
3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024
11100 Euclid Ave
Cleveland Heights, OH 44106
Interoperability endpoints
- sanim36118@ehrdirect.uhhospitals.org
- sanim2573399@direct.sanfordhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301087288 | MI | |
| Pediatric Hematology & Oncology Physician | 2080P0207X | 54658 | MN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301087288 | MI | |
| Pediatric Hematology & Oncology Physician | 2080P0207X | 11958 | ND | Yes |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
Other practice location 1
820 4th St N
Fargo, ND 58102-4539
Phone (701) 234-7544
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16941 | Medicaid | ND |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sanim2573399@direct.sanfordhealth.org |
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All providers in Fargo, ND · Pediatric Hematology & Oncology Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.