Grant Wade Botker, M.D.
Individual provider Active NPI Family Medicine Physician · Ortonville, MN
NPI 1295026532 · NPPES record last updated Feb 28, 2024
Key facts
- NPI
- 1295026532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 57981 (MN)
- Practice address
- 450 Eastvold Ave
Ortonville, MN 56278-1133 - Phone
- (320) 839-6157
- Fax
- (320) 839-3851
- NPI assigned
- Apr 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ortonville Area Health Services
Practice addresses (Care Compare)
1103 S 2ND St
Milbank, SD 57252-3304
Phone (605) 432-4556
450 Eastvold Ave
Ortonville, MN 56278-1252
Phone (320) 839-6157
Hospital & facility affiliations
- Centracare Hospice
- Ortonville Area Health Services
- Sanford Usd Medical Center
- Fairway View Neighborhoods
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.21 of 100
- Quality
- 92.56
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 41.48
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140807002191 | MN | Practitioner - Family Practice | 5294980009 | Reassigns benefits to 2 organizations |
| I20140828000034 | SD | Practitioner - Family Practice | 5294980009 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ortonville Area Health Services | Family Medicine | Current |
Accepting new patients |
| Ortonville Area Health Services | Current |
Accepting new patients | |
| Ortonville Area Health Services | Current | Accepting new patients | |
| Ortonville Area Health Services | Past | Accepting new patients |
Locations
450 Eastvold Ave
Ortonville, MN 56278
Phone (320) 839-2502
1103 S 2nd St
Milbank, SD 57252
Phone (605) 423-4556
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9144 | SD | |
| Family Medicine Physician | 207Q00000X | 57981 | MN | Yes |
Addresses
Primary practice location
450 Eastvold Ave
Ortonville, MN 56278-1133
Mailing address
450 Eastvold Ave
Ortonville, MN 56278-1252
Other providers in Ortonville, MN
- Casey Berg
- Ronald V Beyer
- Big Stone Chiropractic Health Center PC
- Big Stone Community Homes, Inc.
- Big Stone County Family Services
- Eric Marlo Brandriet
- Kalai Ann Brink
- Brown Clinic PLLP
- Carlson Drug Inc
- Brian Carlson
All providers in Ortonville, 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 Feb 28, 2024. 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.