NPIMap

Individual provider Active NPI

Charles J Breen, MD

  • Family Medicine Physician
  • Hillsboro, ND
National Provider Identifier
1114944113
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6161 Issued in ND
Practice address
315 E Caldonia Ave
Hillsboro, ND 58045
Phone
(701) 436-5311
Fax
(701) 436-4514
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6161 ND Primary
Family Medicine Physician 207Q00000X 36008 MN

Addresses

Primary practice location

315 E Caldonia Ave
Hillsboro, ND 58045

Mailing address

315 E Caldonia Ave, PO Box 639
Hillsboro, ND 58045
Phone (701) 436-5311

Other identifiers 1

IdentifierTypeStateIssuer
17292MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050819000059 ND Practitioner - Family Practice 2668402660 Reassigns benefits to 2 organizations
I20090313000211 MN Practitioner - Family Practice 2668402660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

315 E Caledonia Ave
Hillsboro, ND 58045-4701
Phone (701) 636-5311

410 4TH St SW
Mahnomen, MN 56557-4732
Phone (218) 835-2514

445 1St St E
Halstad, MN 56548-4142
Phone (218) 456-2158

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Hospital & facility affiliations

  • Sanford Home Care Fargo Home health agency, Fargo, ND, CCN 357037
  • Hia Hospice Hospice, Fargo, ND, CCN 351500
  • Sanford Hillsboro Hospital, Hillsboro, ND, CCN 351329
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Sanford Mayville Hospital, Mayville, ND, CCN 351309
  • Sanford Hillsboro Nursing home, CCN 35Z329

Merit-based Incentive Payment System (MIPS)

Final score
90.22 of 100Reported as group
Quality
90.28
Promoting interoperability
100
Improvement activities
40
Cost
72.7

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36008MNMDFamily Medicine Physician
6161NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network North CurrentSince Feb 10, 2018 Accepting new patients
Sanford Health Network North Current Accepting new patients
Sanford Medical Center Fargo Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Sanford Health Network North Family Medicine Current Accepting new patients
Sanford Health Network North CurrentSince Feb 10, 2018 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 1, 2022 Accepting new patients
Sanford Health Network North Past Accepting new patients
Halstad Living Center Past Accepting new patients

Locations

445 1st St E
Halstad, MN 56548
Phone (218) 456-2158

414 W Jefferson Ave
Mahnomen, MN 56557
Phone (218) 935-2511

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

407 Washington Ave E
Finley, ND 58230
Phone (701) 524-1005

600 1st St SE
Mayville, ND 58257
Phone (701) 786-4500

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 11

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1114944113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E CALDONIA AVE, PO BOX 639",
            "city": "HILLSBORO",
            "state": "ND",
            "postal_code": "58045",
            "telephone_number": "701-436-5311",
            "fax_number": "701-436-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E CALDONIA AVE",
            "city": "HILLSBORO",
            "state": "ND",
            "postal_code": "58045",
            "telephone_number": "701-436-5311",
            "fax_number": "701-436-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEN",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "6161",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "36008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17292",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, ND

Sources for this page

Verify at the official NPI Registry.