Individual provider Active NPI

Joshua Wynne, MD

  • Cardiovascular Disease Physician
  • Fargo, ND
National Provider Identifier
1376565960
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
9903 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-2371
Fax
(701) 234-3434
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 9903 ND Primary

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 2

IdentifierTypeStateIssuer
373643100MedicaidMN
13308MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwynne2383801@direct.sanfordhealth.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041220000440 ND Practitioner - Cardiovascular Disease (Cardiology) 6800860479 Reassigns benefits to 1 organization
I20070406000179 MN Practitioner - Cardiovascular Disease (Cardiology) 6800860479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Boston University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 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

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

621 Demers Ave
East Grand Forks, MN 56721-1812
Phone (218) 773-5857

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

929 Central Ave NW
East Grand Forks, MN 56721-1917
Phone (218) 773-6800

Hospital & facility affiliations

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 CurrentSince May 23, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients

Locations

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

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

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

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

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

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

Organizations & group practices 2

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 5

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1376565960",
    "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": "701-234-3434"
        },
        {
            "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": "701-234-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ND",
            "license": "9903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373643100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13308",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwynne2383801@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "801 Broadway N",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581023641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.