Dennis G Sollom, MD
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Fargo, ND
NPI 1336170265 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1336170265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 5279 (ND)
- Practice address
- 1702 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 364-3300
- Fax
- (701) 364-8906
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physical Medicine and Rehabilitation
- Education
- University of North Dakota School of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Innovis Health LLC
Practice addresses (Care Compare)
3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000
Hospital & facility affiliations
- Essentia Health
- Essentia Health St Marys - Detroit Lakes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- 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 |
|---|---|---|---|---|
| I20071203000730 | ND | Practitioner - Physical Medicine and Rehabilitation | 4385733070 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovis Health, LLC | Current | Accepting new patients | |
| Innovis Health, LLC. | Current |
Accepting new patients |
Locations
1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300
705 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-2800
3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000
1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 5279 | ND | Yes |
Addresses
Primary practice location
1702 University Dr S
Fargo, ND 58103-4940
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 681203100 | Medicaid | ND | |
| 126895 | Other | ND | UCARE # |
| 911595 | Other | ND | AMERICA'S PPO/ARAZ # |
| HP25769 | Other | ND | HEALTHPARTNERS # |
| ND200062 | Other | ND | LHS # |
| 2300159 | Other | ND | MEDICA # |
| 15146 | Medicaid | ND | |
| 2300113 | Other | ND | MEDICA # |
| DA9011015590 | Other | ND | PREFERRED ONE # |
| 16583SO | Other | ND | MNBS # |
| 2222 | Other | ND | NDBS # |
Other providers in Fargo, ND
- Julia Solem
- Joanna Solhjem
- Solien Spine Associates, PC
- Thomas P Solien
- Mahmoud Lotfy Soliman
- Gail Lorraine Sollom
- Shadline K Solo
- Brent F Solseng
- Raelyn Soltis
- Sharon K Solum
All providers in Fargo, ND · Physical Medicine & Rehabilitation 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 Mar 7, 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.
- 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.