NPIMap

Individual provider Active NPI

Talitha M. Sannes-Venhuizen, M.D.

  • Family Medicine Physician
  • Fargo, ND
National Provider Identifier
1306887286
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46849 Issued in MN
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-2000
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD19725 ME
Family Medicine Physician 207Q00000X 46849 MN Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

410 4th St NW
Mahnomen, MN 56557-4208
Phone (218) 835-2514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050108000024 MN Practitioner - Family PracticePractitioner - Emergency Medicine 3375591175 Reassigns benefits to 7 organizations
I20200409001677 ND Practitioner - Family Practice 3375591175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of North Dakota School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perham Hospital DistrictGroup PAC ID 2264327766, 40 clinicians
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1656

1000 Coney W St
Perham, MN 56573-2102

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

Hospital & facility affiliations

  • Perham Health Hospital, Perham, MN, CCN 241373
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Perham Health Nursing home, CCN 24Z373

Merit-based Incentive Payment System (MIPS)

Final score
87.39 of 100Reported as group
Quality
91.62
Promoting interoperability
100
Improvement activities
40
Cost
66.36

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19725MEMDFamily Medicine Physician
46849MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Perham Hospital District CurrentSince Sep 16, 2021 Accepting new patients
St. Francis Medical Center CurrentSince Sep 23, 2017 Accepting new patients
Sanford Medical Center Fargo Family Medicine CurrentSince Jul 14, 2017 Accepting new patients
St. Francis Medical Center Current Accepting new patients
Perham Hospital District Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 14, 2017 Accepting new patients
Perham Hospital District Current Accepting new patients
Perham Hospital District Family Medicine CurrentSince Sep 16, 2021 Accepting new patients
Cuyuna Regional Medical Center Family Medicine Current Accepting new patients
St Francis Medical Center Past Accepting new patients

Locations

3293 Solutions Ctr
Chicago, IL 60677

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

2400 St Francis Dr
Breckenridge, MN 56520
Phone (218) 643-0226

320 E Main St
Crosby, MN 56441
Phone (218) 546-7000

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

414 W Jefferson Ave
Mahnomen, MN 56557
Phone (218) 935-2511

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

600 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-3311

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 9

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1306887286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 4th St NW",
            "address_purpose": "LOCATION",
            "city": "Mahnomen",
            "state": "MN",
            "postal_code": "565574208",
            "country_code": "US",
            "telephone_number": "218-835-2514",
            "fax_number": "218-835-2720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANNES-VENHUIZEN",
        "first_name": "TALITHA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD19725",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "46849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.