NPIMap

Individual provider Active NPI

Jane Ostlie, MD

  • Family Medicine Physician
  • Mayville, ND
National Provider Identifier
1063672749
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11491 Issued in ND
Practice address
600 1St St SE
Mayville, ND 58257-1518
Phone
(701) 788-4500
Fax
(701) 788-4500
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11491 ND Primary
Family Medicine Physician 207Q00000X TRL10930 ND

Addresses

Primary practice location

600 1St St SE
Mayville, ND 58257-1518

Mailing address

600 1St St SE
Mayville, ND 58257-1518
Phone (701) 788-4500

Other identifiers 1

IdentifierTypeStateIssuer
15151MedicaidND

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
I20100430000224 ND Practitioner - Family Practice 4880721463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

600 1St St SE
Mayville, ND 58257-1518
Phone (701) 788-4500

Hospital & facility affiliations

  • Sanford Home Care Fargo Home health agency, Fargo, ND, CCN 357037
  • Hia Hospice Hospice, Fargo, ND, CCN 351500
  • Sanford Mayville Hospital, Mayville, ND, CCN 351309
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Sanford Hillsboro Hospital, Hillsboro, ND, CCN 351329
  • Northwood Deaconess Health Center Hospital, Northwood, ND, CCN 351312
  • Luther Memorial Home Nursing home, Mayville, ND, CCN 355040
  • Sanford Mayville Nursing home, CCN 35Z309

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11491NDMDFamily Medicine Physician
TRL10930NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Family Medicine CurrentSince Aug 13, 2022 Accepting new patients
Sanford Health Network North CurrentSince Mar 3, 2018 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 13, 2022 Accepting new patients
Luther Memorial Home Past Accepting new patients

Locations

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

407 Washington Ave E
Finley, ND 58230
Phone (701) 524-1005

42 6th Ave SE
Mayville, ND 58257
Phone (701) 786-3800

600 1st St SE
Mayville, ND 58257
Phone (701) 786-4500

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1063672749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 1ST ST SE",
            "city": "MAYVILLE",
            "state": "ND",
            "postal_code": "582571518",
            "telephone_number": "701-788-4500",
            "fax_number": "701-788-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 1ST ST SE",
            "city": "MAYVILLE",
            "state": "ND",
            "postal_code": "582571518",
            "telephone_number": "701-788-4500",
            "fax_number": "701-788-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTLIE",
        "first_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "11491",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "TRL10930",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15151",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayville, ND

Sources for this page

Verify at the official NPI Registry.