Active NPI
Erica Martin-Macintosh, M.D.
- Diagnostic Radiology Physician
- Fargo, ND
National Provider Identifier
1124344858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 54511
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-2345
- NPI assigned
- Apr 20, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 54511 | MN | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 105576 | MN |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENROLLED | Medicaid | MN |
Other names 1
- Erica Martin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110921000700 | MN | Practitioner - Diagnostic Radiology | 0648441741 | Reassigns benefits to 2 organizations |
| I20160831002295 | ND | Practitioner - Diagnostic Radiology | 0648441741 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54511 | MN | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Health Network North | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Health Network North | Current | Accepting new patients | |
| Sanford Health Network North | Current | Accepting new patients | |
| Lisbon Area Health Services | Past | Accepting new patients | |
| Mayo Clinic | Past | Accepting new patients |
Locations
1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747
801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Organizations & group practices 7
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.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
- Family Medicine Physician
- Thief River Falls, MN
- NPI 1144401514
-
- Community/Retail Pharmacy
- Thief River Falls, MN
- NPI 1346423373
-
- Medicare Defined Swing Bed Hospital Unit
- Lisbon, ND
- NPI 1033292875
-
- Clinical Medical Laboratory
- Rochester, MN
- NPI 1083249577
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Multi-Specialty Clinic/Center
- Thief River Falls, MN
- NPI 1861895906
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of North Dakota School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
1412 Main St
Hawley, MN 56549
Phone (218) 483-3564
3001 Sanford Pkwy
Thief River Falls, MN 56701-2700
Phone (701) 780-4348
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000
Hospital & facility affiliations
- Sanford Medical Center Fargo
- Perham Health
- Sanford Thief River Falls Medical Center
- Sanford Mayville
- Sanford Hillsboro
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 1-10 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636761600000",
"number": "1124344858",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-2345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN-MACINTOSH",
"first_name": "ERICA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-20",
"last_updated": "2021-11-13",
"certification_date": "2021-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "54511",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "105576",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ERICA",
"last_name": "MARTIN",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2021; 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.