Judy A Bellanger-Dahl, PA-C
Individual provider Active NPI Physician Assistant · Perham, MN
NPI 1265470447 · NPPES record last updated Aug 4, 2022
Key facts
- NPI
- 1265470447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 1000 Coney St W
Perham, MN 56573-2102 - Phone
- (218) 347-1200
- Fax
- (218) 347-4043
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of North Dakota School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Perham Hospital District
First Care Medical Services
Practice addresses (Care Compare)
1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1656
1000 Coney W St
Perham, MN 56573-2102
121 Central St W
Bagley, MN 56621-4393
Phone (218) 694-6281
400 Governor St
Oklee, MN 56742-4227
Phone (218) 796-4525
Hospital & facility affiliations
- Perham Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.39 of 100
- Quality
- 91.62
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 66.36
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060322000118 | MN | Practitioner - Physician Assistant | 8921035700 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0325 | ND | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifecare Medical Center | Current |
Accepting new patients | |
| First Care Medical Services | Current |
Accepting new patients | |
| Perham Hospital District | Current |
Accepting new patients | |
| Lifecare Medical Center | Current |
Accepting new patients | |
| First Care Medical Services | Current |
Accepting new patients | |
| Perham Hospital District | Past | Accepting new patients | |
| Pipestone County Medical Center | Past | Accepting new patients |
Locations
121 Central St W
Bagley, MN 56621
Phone (218) 694-6281
900 Hilligoss Blvd SE
Fosston, MN 56542
Phone (218) 435-1133
105 Otter Dr
Ottertail, MN 56571
Phone (218) 367-6111
1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200
715 Delmore Dr
Roseau, MN 56751
Phone (218) 463-2500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 9616 | MN | |
| Medical Physician Assistant | 363AM0700X | 0325 | ND | |
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
1000 Coney St W
Perham, MN 56573-2102
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 318G9BE | Other | MNBCBS | |
| 23099 | Other | NDBCBS | |
| 924632100 | Medicaid | MN |
Other names
- Judy Johnson
Other providers in Perham, MN
- Levi Matthew Baumgart
- Becker Optometry PC
- Becker Optometry, PC
- Corey Becker
- Taylor M Beiswenger
- Katie Benke
- Karissa Berg
- Rebecca Berg
- Rayna Bergseth
- Cassie Beseman
All providers in Perham, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.