Michael T. Hill, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP5479 Issued in MN

Practice address

1656 Central St W
Bagley, MN 56621

Phone

(218) 694-2384

Fax

(218) 694-6687

NPI assigned

Dec 21, 2009

Last updated

Oct 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, 349 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment Care Compare group NPD
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149
  NPD
• Sanford Health of Northern Minnesota

  dba Sanford Bagley Medical Center

  • Critical Access Hospital
  • Bagley, MN
  • NPI 1932472255
  NPD
• Jean C. Christensen

  • Community/Behavioral Health Agency
  • Bemidji, MN
  • NPI 1184024135
  NPD (past)

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1104155175",
    "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": "218-694-2384",
            "fax_number": "218-694-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CENTRAL ST W",
            "city": "BAGLEY",
            "state": "MN",
            "postal_code": "56621",
            "telephone_number": "218-694-2384",
            "fax_number": "218-694-6687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "722 15th St NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "56601",
            "country_code": "US",
            "telephone_number": "218-751-3280",
            "fax_number": "218-751-3298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILL",
        "first_name": "MICHAEL",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-21",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabelle Grover
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• Tammy Rae Hanse, RN
• Janet Rene Haugen
• Sarah Heider, DPT
• Melissa Nicole Jenson, RN
• Mary Elizabeth Jones, DDS
• Klettenberg Chiropractic PLLC
• Logan Klettenberg, D.C.
• Kim Louise Lavine, OTR/L

• Psychologist in Bagley, MN
• Providers in Bagley, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.

Verify at the official NPI Registry.