Maren Lynn Mangardich

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R42081 Issued in ND

Practice address

860 S Columbia Rd
Grand Forks, ND 58201-4028

Phone

(701) 780-5000

NPI assigned

Jul 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altru Health System 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552

  ND

  Medicare reassignment Care Compare group NPD
• Altru Health System

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  Care Compare group NPD
• Altru Health System

  • Prosthetic/Orthotic Supplier
  • Grand Forks, ND
  • NPI 1033257704
  Care Compare group
• Altru Health System

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Devils Lake, ND
  • NPI 1124117692
  Care Compare group
• Altru Health System

  • Clinic Pharmacy
  • Grand Forks, ND
  • NPI 1144368085
  Care Compare group
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare group
• Altru Health System

  • Home Health Agency
  • Grand Forks, ND
  • NPI 1346339850
  Care Compare group
• Altru Health System

  • Home Infusion Therapy Pharmacy
  • Grand Forks, ND
  • NPI 1497844906
  Care Compare group
• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1811617103
  Care Compare group
• Altru Health System

  • Rural Health Clinic/Center
  • Devils Lake, ND
  • NPI 1912632449
  Care Compare group
• Altru Health System

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Roseau, MN
  • NPI 1144518549
  Care Compare group
• Altru Health System

  • Rural Health Clinic/Center
  • Thief River Falls, MN
  • NPI 1285074328
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1104443449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014183",
            "telephone_number": "701-780-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014028",
            "telephone_number": "701-780-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGARDICH",
        "first_name": "MAREN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R42081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Malevich, PHD
• Kailey Ann Maley
• Kathryn E Malott, PT
• Stephen Todd Malutich, D.O.
• Antranik Mangardich, MD
• Manke Family Dentistry
• Lauren Manke, D.D.S.
• Rory Bret Manke, D.D.S.
• Wendy Ann Mankie, LRD
• Maria Mann

• All providers in Grand Forks, ND
• Psychiatric/Mental Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.