Benjamin Ray Campbell, M.D.
Individual provider Active NPI Otolaryngology Physician · Grand Forks, ND
NPI 1306309604 · NPPES record last updated Aug 21, 2024
Key facts
- NPI
- 1306309604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 20760 (ND)
- Practice address
- Altru Professional Center
4440 S Washington St
Grand Forks, ND 58201 - Phone
- (615) 322-5000
- NPI assigned
- Apr 12, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 14
Medicare Care Compare profile
- Specialty
- Otolaryngology
- Education
- Vanderbilt University School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Altru Health System
Practice addresses (Care Compare)
1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000
1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000
4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000
711 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-1365
715 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-2500
Hospital & facility affiliations
- Altru Hospital
- Lifecare Medical Center
- Sanford Thief River Falls Medical Center
- Unity Medical Center
- Riverview Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ND, MN
- 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 |
|---|---|---|---|---|
| I20240924002910 | ND | Practitioner - Otolaryngology | 7416283866 | Reassigns benefits to 1 organization |
| I20250103000741 | MN | Practitioner - Otolaryngology | 7416283866 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altru Health System | Current |
Accepting new patients | |
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current |
Accepting new patients | |
| Altru Health System | Current |
Accepting new patients |
Locations
711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365
1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000
4440 S Washington St
Fl 1
Grand Forks, ND 58201
4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 20760 | ND | Yes |
Addresses
Primary practice location
Altru Professional Center
4440 S Washington St
Grand Forks, ND 58201
Mailing address
PO Box 13780
Grand Forks, ND 58208
Phone (701) 780-1891
Other providers in Grand Forks, ND
- Christina Cadena
- Mercedes Caelwaerts
- Melanie Sue Cairns
- Cambian Behavioral Health PLLC
- Yara Letitia Cameron
- Cassie Campbell
- Cathie N Campbell
- Hector O'Niel Campbell
- John A Campbell
- Sara Campbell
All providers in Grand Forks, ND · Otolaryngology Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 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.