Individual provider Active NPI

Oscar Fernandez, M.D.

  • Family Medicine Physician
  • Lisbon, ND
National Provider Identifier
1184613465
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6119 Issued in ND
Practice address
905 Main St
Lisbon, ND 58054-4334
Phone
(701) 683-6400
NPI assigned
Oct 19, 2005
Last updated
May 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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 6119 ND Primary

Addresses

Primary practice location

905 Main St
Lisbon, ND 58054-4334

Mailing address

905 Main St
Lisbon, ND 58054-4334
Phone (701) 683-6400

Other identifiers 1

IdentifierTypeStateIssuer
12153MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170908000239 TX Practitioner - Family PracticePractitioner - Emergency Medicine 4880630730 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3906NDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Health & Human Services PHS IHS CurrentSince Dec 30, 2019 Accepting new patients
DHHS IHS Phoenix Area Family Medicine CurrentSince Jul 27, 2017 Accepting new patients
Southwest Healthcare Services Current Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Mar 28, 2023 Accepting new patients
Lisbon Area Health Services Current Accepting new patients
CHI Health Connect at Home-Fargo Past Accepting new patients
Family Medical Clinic PC Family Medicine PastSince Sep 1, 2000 Accepting new patients

Locations

3276 Solutions Ctr
Chicago, IL 60677

350 E Devon Ave
Itasca, IL 60143

425 7th St NW
Cass Lake, MN 56633
Phone (218) 335-3200

802 2nd St NW
Bowman, ND 58623
Phone (701) 523-3214

802 2nd St NW
Ste 1
Bowman, ND 58623
Phone (701) 523-5555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1184613465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MAIN ST",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580544334",
            "telephone_number": "701-683-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MAIN ST",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580544334",
            "telephone_number": "701-683-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "OSCAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "6119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12153",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, ND

Sources for this page

Verify at the official NPI Registry.