Justin Quo, M.D.
Individual provider Active NPI Family Medicine Physician · Baudette, MN
NPI 1285947556 · NPPES record last updated Mar 15, 2023
Key facts
- NPI
- 1285947556
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 56409 (MN)
- Practice address
- 600 Main Ave S
Baudette, MN 56623-2855 - Phone
- (218) 634-1655
- Fax
- (218) 634-1016
- NPI assigned
- Jul 15, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 5
Owned or controlled facilities with NPI records 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakewood Health Center
Practice addresses (Care Compare)
600 Main Ave S
Baudette, MN 56623-2855
Phone (218) 634-1655
Hospital & facility affiliations
- Hia Hospice
- Lakewood Health Center
- Sanford Bemidji Medical Center
- Lakewood Care Center
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: Yes
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Lakewood Health Center |
Hospital | Corporate Director | Jan 1, 2014 |
| CHI Lakewood Health |
Hospital | Corporate Director | Jan 1, 2014 |
| Lakewood Health Center |
Skilled nursing facility | Corporate Director | Dec 1, 2013 |
| CHI Health at Home |
Home health agency | Corporate Director | Oct 1, 2025 |
| Unity Family Healthcare |
Rural health clinic | Corporate Director | Oct 1, 2025 |
| Lakewood Health Center |
Rural health clinic | Corporate Director | Apr 2, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130826001067 | MN | Practitioner - Family Practice | 9931342714 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301097176 | MI | MD | Family Medicine Physician |
| 56409 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakewood Health Center | Current |
Accepting new patients | |
| Lakewood Health Center | Current |
Accepting new patients | |
| Lakewood Health Center | Past | Accepting new patients | |
| Lakewood Health Center | Past | Accepting new patients |
Locations
3470 Solutions Ctr
Chicago, IL 60677
600 Main Ave S
Birchdale, MN 56623
Phone (218) 634-1655
4784 Amber Valley Pkwy S
Fargo, ND 58104
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301097176 | MI | |
| Family Medicine Physician | 207Q00000X | 56409 | MN | Yes |
Addresses
Primary practice location
600 Main Ave S
Baudette, MN 56623-2855
Mailing address
600 Main Ave S
Baudette, MN 56623-2855
Phone (218) 634-1655
Other providers in Baudette, MN
- Amy Renee Moser
- Brent Noble
- Stuart Michael Noble
- Brennin Kyle O'Brien
- Psychenutrition
- Sanford Health of Northern Minnesota
- SMN Inc
- Taylored Care Services LLC
- Thrifty Drug Stores Inc
- Shawna Renae Brasgalla Wendler
All providers in Baudette, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2023. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.