NPIMap

Individual provider Active NPI

Shyleen Hall, MD

  • Family Medicine Physician
  • Grand Forks, ND
National Provider Identifier
1124687694
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RL15786 Issued in ND
Practice address
725 Hamline St
Grand Forks, ND 58203-2819
Phone
(701) 780-6814
Fax
(701) 780-4391
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL15786 ND Primary

Addresses

Primary practice location

725 Hamline St
Grand Forks, ND 58203-2819

Mailing address

725 Hamline St
Grand Forks, ND 58203-2819
Phone (701) 780-6814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231005003437 TX Practitioner - Family Practice 9234463712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quentin N Burdick Comprehensive Health Care FacilityGroup PAC ID 5496651853, 38 clinicians

Practice addresses (Care Compare)

PO Box
160 1300 Hospital Loop
Belcourt, ND 58316-0160

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
42.91 of 100Reported as group
Quality
5.54
Improvement activities
40
Cost
66.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RL15786NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Sep 11, 2023 Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1124687694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 HAMLINE ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032819",
            "telephone_number": "701-780-6814",
            "fax_number": "701-780-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 HAMLINE ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032819",
            "telephone_number": "701-780-6814",
            "fax_number": "701-780-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SHYLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL15786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.