NPIMap

Individual provider Active NPI

Shan M Flatt, MD

  • Family Medicine Physician
  • Alexandria, MN
National Provider Identifier
1265728026
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
107477 Issued in MN
Practice address
610 30TH Ave W
Alexandria, MN 56308-3426
Phone
(320) 763-2540
Fax
(320) 763-5749
NPI assigned
Jun 21, 2011
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 107477 MN Primary

Addresses

Primary practice location

610 30TH Ave W
Alexandria, MN 56308-3426

Mailing address

610 30TH Ave W
Alexandria, MN 56308-3426
Phone (320) 763-2540

Other identifiers 3

IdentifierTypeStateIssuer
107477OtherMNMEDICAL LICENSE
1265728026OtherMNNPI
1265728026MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20140804000450 MN Practitioner - Family Practice 6800013509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

610 30TH Ave W
Alexandria, MN 56308-3426
Phone (320) 763-5123

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions23
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107477MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Hospital Current Accepting new patients
Alexandria Clinic PA Current Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Douglas County Hospital Past Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

610 30th Ave W
Alexandria, MN 56308
Phone (320) 763-2540

Interoperability endpoints

  • Direct secure messaging: sflatt190146@direct.centracare.com

Organizations & group practices 6

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 3

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265728026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-2540",
            "fax_number": "320-763-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-2540",
            "fax_number": "320-763-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLATT",
        "first_name": "SHAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "107477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "107477",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265728026",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265728026",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.