Matthew J Dammeyer, MD
Individual provider Active NPI Family Medicine Physician · Benson, MN
NPI 1083838403 · NPPES record last updated Sep 7, 2016
Key facts
- NPI
- 1083838403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 50490 (MN)
- Practice address
- 125 20TH St SW
Benson, MN 56215-2430 - Phone
- (320) 843-9929
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Norton Sound Health Corporation
Practice addresses (Care Compare)
1000 Greg Kruschek Ave
Nome, AK 99762-0966
Phone (907) 443-3311
Hospital & facility affiliations
- Norton Sound Regional Hospital
- Sanford Thief River Falls Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in ND, MN, WI, AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080514000137 | ND | Practitioner - Family Practice | 8921177114 | Reassigns benefits to 1 organization |
| I20090826000426 | MN | Practitioner - Family Practice | 8921177114 | Reassigns benefits to 8 organizations |
| I20170110002649 | WI | Practitioner - Family Practice | 8921177114 | Reassigns benefits to 2 organizations |
| I20200508002429 | AK | Practitioner - Family Practice | 8921177114 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50490 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Medical Center Inc | Current |
Accepting new patients | |
| Sanford Health Network North | Current |
Accepting new patients | |
| Memorial Medical Center Inc | Current |
Accepting new patients | |
| Astera Health | Current |
Accepting new patients | |
| Mercy Hospital of Devils Lake | Current |
Accepting new patients | |
| Sanford Health Network North | Current |
Accepting new patients | |
| Mercy Hospital of Devils Lake | Current |
Accepting new patients | |
| Lake View Memorial Hospital, Inc | Current | Accepting new patients | |
| Spooner Health System, Inc. | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current | Accepting new patients | |
| Lake View Clinic | Family Medicine | Current |
Accepting new patients |
| Cook County Hospital District | Current |
Accepting new patients | |
| Lake View Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Current |
Accepting new patients | |
| Astera Health | Current | Accepting new patients | |
| Sanford Health Network North | Current | Accepting new patients | |
| Astera Health | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Family Medicine | Current | Accepting new patients |
| Glacial Ridge Hospital District | Current |
Accepting new patients |
Locations
3290 Solutions Ctr
Chicago, IL 60677
29980 Network Pl
Chicago, IL 60673
712 S Cascade St
Fergus Falls, MN 56537
10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157
417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157
515 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-3040
1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747
3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240
325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520
415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510
1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131
1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/glac-1755385c
- mjdammeyer@direct.nshcorp.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 50490 | MN | Yes |
Addresses
Primary practice location
125 20TH St SW
Benson, MN 56215-2430
Mailing address
125 20TH St SW
Benson, MN 56215-2430
Phone (320) 843-9929
Other providers in Benson, MN
- Centracare Health - Benson LLC
- Ginger Louise Claussen
- Countryside Public Health Service
- County of Swift Ind School District 777
- Cura of Benson LLC
- Zackery Deal
- Gary Lee Donovan
- Karen T Dorn
- Dean O Erickson
- Mary J Felt
All providers in Benson, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2016. 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.
- 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.