NPIMap

Individual provider Active NPI

Todd W Schaffer, MD

  • Family Medicine Physician
  • Bismarck, ND
National Provider Identifier
1063499879
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9433 Issued in ND
Practice address
3318 N 14TH St
Bismarck, ND 58503-1614
Phone
(701) 323-8300
Fax
(701) 323-8305
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9433 ND Primary

Addresses

Primary practice location

3318 N 14TH St
Bismarck, ND 58503-1614

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other identifiers 5

IdentifierTypeStateIssuer
25689OtherNDBLUE CROSS BLUE SHIELD ND
81335MedicaidND
P00246702OtherNDRAILROAD MEDICARE
12618MedicaidND
407241040375OtherNDPREFERREDONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000668 ND Practitioner - Family Practice 9436147121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Nov 7, 2014 Accepting new patients
Sanford Bismarck Family Medicine CurrentSince Nov 7, 2014 Accepting new patients
Center for Psychiatric Care PastSince Aug 28, 2000 Accepting new patients
Carrington Health Center Family Medicine Past Accepting new patients
Carrington Health Center Family Medicine Past Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

820 5th St N
Carrington, ND 58421
Phone (701) 399-0123

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SanfordBismarck, ND, CCN 350015 Hospital Corporate Officer
W-2 Managing Employee		 Nov 1, 2021
Nov 1, 2021
Sanford Home CareMandan, ND, CCN 357029 Home health agency Corporate Officer
W-2 Managing Employee		 Nov 1, 2021
Nov 1, 2021
Sanford Home CareMandan, ND, CCN 351504 Hospice Corporate Officer
W-2 Managing Employee		 Nov 1, 2011
Nov 1, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1063499879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3318 N 14TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031614",
            "telephone_number": "701-323-8300",
            "fax_number": "701-323-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFFER",
        "first_name": "TODD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "9433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ND",
            "identifier": "25689",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81335",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00246702",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12618",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "407241040375",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.