James E Surdy, M.D.
Individual provider Active NPI Specialist · Hallock, MN
NPI 1083705206 · NPPES record last updated Jan 15, 2013
Key facts
- NPI
- 1083705206
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 33831 (MN)
- Practice address
- 1010 S Birch Ave
Hallock, MN 56728-4215 - Phone
- (218) 843-2165
- Fax
- (218) 843-8879
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 11
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Minnesota Medical School, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kittson Memorial Hospital Association
Practice addresses (Care Compare)
1010 S Birch Ave
Hallock, MN 56728-4215
Phone (218) 843-3612
Hospital & facility affiliations
- Kittson Healthcare
- Hia Hospice
- Kittson Healthcare
- Altru Hospital
- Sanford Medical Center Fargo
- Kittson Healthcare
- Karlstad Healthcare Center Inc
- Kittson Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Karlstad Healthcare Center, Inc |
Skilled nursing facility | W-2 Managing Employee | Apr 1, 2024 |
| Kittson Memorial Hospital Association |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Nov 1, 2016 Nov 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041007000153 | MN | Practitioner - Internal Medicine | 4688633449 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kittson Memorial Hospital Association | Current |
Accepting new patients | |
| Kittson Memorial Hospital Association | Current |
Accepting new patients | |
| McAllen Rutz Eye Clinic PA | Past |
Accepting new patients | |
| Lakeside Medical Center, Inc. | Past | Accepting new patients | |
| Karlstad Healthcare Center, Inc | Past | Accepting new patients | |
| Kittson Memorial Hospital Association | Past | Accepting new patients |
Locations
1010 S Birch Ave
Hallock, MN 56728
Phone (218) 843-3612
205 Roosevelt Ave W
Karlstad, MN 56732
Phone (218) 436-2251
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 33831 | MN | Yes |
Addresses
Primary practice location
1010 S Birch Ave
Hallock, MN 56728-4215
Mailing address
1010 S Birch Ave
Hallock, MN 56728-4215
Phone (218) 843-2165
Other providers in Hallock, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2013. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.