NPIMap

Individual provider Active NPI

Al M Shana, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Fargo, ND
National Provider Identifier
1205889748
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
10140 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 781-3444
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35099267 OH
Nephrology Physician 207RN0300X 35099267 OH
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 10140 ND Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 781-3444

Other practice location 1

4760 E Galbraith Rd
Cincinnati, OH 45236-6703
Phone (513) 475-8524

Other identifiers 2

IdentifierTypeStateIssuer
0065902MedicaidOH
7100146510MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MO, MN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20061016000110 ND Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Nephrology 6608872692 Reassigns benefits to 1 organization
I20190930002483 MO Practitioner - Critical Care (Intensivists) 6608872692 Reassigns benefits to 2 organizations
I20250911002062 MN Practitioner - Critical Care (Intensivists) 6608872692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Landmark Hospital of Joplin LLCGroup PAC ID 5698870822, 8 clinicians
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Landmark Hospital of Columbia LLCGroup PAC ID 2062568025, 8 clinicians

Practice addresses (Care Compare)

1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5000

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

2040 W 32ND St
Joplin, MO 64804-3512
Phone (417) 627-1300

2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000

604 Old 63
Columbia, MO 65201-4557
Phone (573) 499-6632

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35099267OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Landmark Hospital of Joplin, LLC CurrentSince Dec 1, 2022 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Sep 1, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Tampa General Hospital Current Accepting new patients
Landmark Hospital of Columbia LLC CurrentSince Aug 20, 2019 Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

604 Old Highway 63 N
Columbia, MO 65201
Phone (573) 499-6600

3255 Independence St
Cpe Girardeau, MO 63701
Phone (573) 331-8026

2040 W 32nd St
Joplin, MO 64804
Phone (417) 627-1300

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

5225 23rd Ave S
#I94
Fargo, ND 58104

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

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

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: ashana340344@direct.tgh.org

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.

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1205889748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-781-3444"
        },
        {
            "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": "701-781-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4760 E Galbraith Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452366703",
            "country_code": "US",
            "telephone_number": "513-475-8524",
            "fax_number": "513-475-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANA",
        "first_name": "AL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35099267",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35099267",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "ND",
            "license": "10140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065902",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100146510",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.