NPIMap

Individual provider Active NPI

Daniel J Margo, M.D.

  • Surgery Physician
  • Grand Rapids, MN
National Provider Identifier
1083727200
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39379 Issued in MN
Practice address
1542 Golf Course Rd
Grand Rapids, MN 55744-9603
Phone
(218) 327-7973
Fax
(218) 327-3245
NPI assigned
Aug 15, 2006
Last updated
Oct 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39379 MN Primary

Addresses

Primary practice location

1542 Golf Course Rd
Grand Rapids, MN 55744-9603

Mailing address

520 NW 1St Ave
Ste 5
Grand Rapids, MN 55744-2776
Phone (218) 327-7973

Other identifiers 2

IdentifierTypeStateIssuer
274517800MedicaidMN
97B19MAOtherMNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20031209000272 MN Practitioner - General Surgery 2860398187 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

258 Pine Tree Dr
Bigfork, MN 56628-4340
Phone (218) 743-3177

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39379MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
International Falls Memorial Hospital Association CurrentSince Jul 21, 2017 Accepting new patients
International Falls Memorial Hospital Association CurrentSince Jul 21, 2017 Accepting new patients
Northern Itasca Hospital District CurrentSince Jul 1, 2017 Accepting new patients
Lakewood Health Center CurrentSince Nov 1, 2023 Accepting new patients
Lakewood Health Center Current Accepting new patients
Lakeview Behavioral Health LLC PastSince Apr 15, 2016 Accepting new patients
Clearwater County Memorial Hospital Past Accepting new patients
Essentia Health Virginia, LLC Past Accepting new patients

Locations

600 Main Ave S
Birchdale, MN 56623
Phone (218) 634-1655

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

Interoperability endpoints

  • Direct secure messaging: danielmargo@normd.allscriptsdirect.net
  • Direct secure messaging: dmargo442930@fairview.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1083727200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 NW 1ST AVE",
            "address_2": "STE 5",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442776",
            "telephone_number": "218-327-7973",
            "fax_number": "218-327-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557449603",
            "telephone_number": "218-327-7973",
            "fax_number": "218-327-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGO",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "39379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274517800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97B19MA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

Verify at the official NPI Registry.