Individual provider Active NPI

Heeraimangalore S Manjunath, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Fargo, ND
National Provider Identifier
1366472441
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
9450 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-2371
Fax
(701) 234-3813
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 9450 ND Primary
Cardiovascular Disease Physician 207RC0000X 9450 ND

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2371

Other identifiers 17

IdentifierTypeStateIssuer
2259002OtherNDAMERICA'S PPO/ARAZ #
HP48027OtherNDHEALTHPARTNERS #
137120OtherNDUCARE #
27208OtherNDND BCBS
917D5MAOtherNDMNBS #
12427MedicaidND
2501717OtherNDMEDICA #
2502164OtherMEDICA
806926300MedicaidMN
DA9011042786OtherNDPREFERRED ONE #
25027OtherNDNDBS #
37999OtherNDLHS #
600G7MAOtherMNMN BCBS
HP48027OtherHEALTPARTNERS
1042786OtherPREFERREDONE
806926300MedicaidND
2501505OtherNDMEDICA #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041213001000 ND Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5193782951 Reassigns benefits to 1 organization
I20080121000080 MN Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5193782951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant Cardiology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

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

21 Wiley Ave S
Lidgerwood, ND 58053-4001
Phone (701) 538-4189

211 E Mill St
Pelican Rapids, MN 56572-4234
Phone (218) 863-6100

300 2ND Ave NE
Jamestown, ND 58401-3373
Phone (701) 251-6000

332 2ND Ave N
Wahpeton, ND 58075-4528
Phone (701) 642-7000

401 12TH St N
Wheaton, MN 56296-1070
Phone (320) 563-8971

420 S 7TH St
Oakes, ND 58474-2024
Phone (701) 742-3267

520 Chautauqua Blvd
Valley City, ND 58072-3145
Phone (701) 845-6000

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

618 14TH Ave NE
Devils Lake, ND 58301-2808
Phone (701) 544-7000

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Perham Health Hospital, Perham, MN, CCN 241373
  • Sanford Mayville Hospital, Mayville, ND, CCN 351309
  • Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015
  • Sanford Hillsboro Hospital, Hillsboro, ND, CCN 351329

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
88.99 of 100Reported as group
Quality
92.39
Promoting interoperability
100
Improvement activities
40
Cost
70.9

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Family Medicine CurrentSince May 25, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 25, 2011 Accepting new patients
Sanford Health Network North CurrentSince Feb 10, 2018 Accepting new patients
Sanford Health Network North Current Accepting new patients
Michael Yoong Mdpa Family Medicine Past Accepting new patients
Maryland Cardiology Associates, LLC Past Accepting new patients
Sanford Medical Center Fargo Cardiovascular Disease Past Accepting new patients

Locations

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

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240

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

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

904 5th Ave NE
Jamestown, ND 58401
Phone (701) 253-4000

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

Organizations & group practices 7

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.

Hospital & facility affiliations 11

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1366472441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2371",
            "fax_number": "701-234-3813"
        },
        {
            "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": "701-234-2371",
            "fax_number": "701-234-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANJUNATH",
        "first_name": "HEERAIMANGALORE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "ND",
            "license": "9450",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ND",
            "license": "9450",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
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        },
        {
            "code": "01",
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            "issuer": "HEALTHPARTNERS #",
            "identifier": "HP48027",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE #",
            "identifier": "137120",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BCBS",
            "identifier": "27208",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBS #",
            "identifier": "917D5MA",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12427",
            "state": "ND"
        },
        {
            "code": "01",
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            "issuer": "MEDICA #",
            "identifier": "2501717",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2502164",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806926300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE #",
            "identifier": "DA9011042786",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS #",
            "identifier": "25027",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LHS #",
            "identifier": "37999",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BCBS",
            "identifier": "600G7MA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTPARTNERS",
            "identifier": "HP48027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1042786",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806926300",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "2501505",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.