Active NPI
Max Disse, M.D
- Dermatology Physician
- Detroit Lakes, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 67942
- Practice address
- 1245 Washington Ave
Detroit Lakes, MN 56501-3905 - Phone
- (218) 846-2000
- NPI assigned
- Mar 24, 2016
- Last updated
- Aug 27, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Dermatology Physician | 207N00000X | 67942 | MN | Primary |
Addresses
Primary practice location
1245 Washington Ave
Detroit Lakes, MN 56501-3905
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (218) 849-4891
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Minnesota Medical School, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1200
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.39 of 100
- Quality
- 91.62
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 66.36
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 85 |
| Removal of skin lesions | 675 |
| Removal or shaving of skin growth | 60 |
| Skin biopsy | 290 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67942 | MN | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients |
Locations
1245 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 846-2000
4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200
1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
MN
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Perham Health
- Family Medicine Physician
- Perham, MN
- NPI 1457631814
Hospital
-
dba Sanford Bemidji
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Hospital
-
dba Sanford Physical Therapy
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1073975462",
"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": "218-849-4891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1245 WASHINGTON AVE",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013905",
"telephone_number": "218-846-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISSE",
"first_name": "MAX",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-24",
"last_updated": "2020-08-27",
"certification_date": "2020-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MN",
"license": "67942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.