Derek M Brickner, MD
Individual provider Active NPI Family Medicine Physician · Jamestown, ND
NPI 1346405602 · NPPES record last updated Mar 25, 2022
Key facts
- NPI
- 1346405602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 11895 (ND)
- Practice address
- 300 2ND Ave NE
Jamestown, ND 58401-3373 - Phone
- (701) 251-6000
- NPI assigned
- Jul 25, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 12
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Dakota School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Lutheran Charity Association
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000
2422 20TH St SW
Jamestown, ND 58401-6201
Phone (701) 252-1050
300 2ND Ave NE
Jamestown, ND 58401-3373
Phone (701) 251-6000
520 Chautauqua Blvd
Valley City, ND 58072-3145
Phone (701) 845-6000
Hospital & facility affiliations
- Jamestown Regional Medical Center Home Health
- Hia Hospice
- Jamestown Regional Medical Center
- Sanford Medical Center Fargo
- CHI Mercy Health
- Sanford Medical Center Bismarck
- SMP Health - Ave Maria
- Eventide Jamestown
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 13 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 11 |
| Removal of skin lesions | 85 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
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
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Eventide Jamestown |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2024 Mar 27, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111011000250 | ND | Practitioner - Family Practice | 6002088325 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TEP5877 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Charity Association | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Family Medicine | Current |
Accepting new patients |
| Lutheran Charity Association | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Lutheran Charity Association | Past | Accepting new patients | |
| Sisters of Mary of the Presentation Long Term Care | Past | Accepting new patients | |
| Sanford Medical Center Fargo | Past | Accepting new patients |
Locations
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
300 2nd Ave NE
Jamestown, ND 58401
Phone (701) 251-6000
2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Interoperability endpoints
- dbrickner3255789@direct.sanfordhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | TEP5877 | NE | |
| Family Medicine Physician | 207Q00000X | 11895 | ND | Yes |
Addresses
Primary practice location
300 2ND Ave NE
Jamestown, ND 58401-3373
Mailing address
300 2ND Ave NE
Jamestown, ND 58401-3373
Phone (701) 251-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16213 | Medicaid | ND | |
| 47055301100 | Medicaid | NE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dbrickner3255789@direct.sanfordhealth.org |
Other providers in Jamestown, ND
- Kathryn Bradley
- Renee Brady
- Jason J Braun
- Breck Leach DMD, PLLC
- Makenzie Julia Breitbach
- Bridgewell
- Bridgewell LLC
- Riley Britton
- Alan J Broadhead
- Chasity Brobst
All providers in Jamestown, ND · Family Medicine 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 25, 2022. 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.