NPIMap

Individual provider Active NPI

Donald J Stallman, MD

  • Diagnostic Radiology Physician
  • Fargo, ND
National Provider Identifier
1386665503
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
7467 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-2406
Fax
(701) 234-6072
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 7467 ND Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (701) 234-2000

Other identifiers 8

IdentifierTypeStateIssuer
81407MedicaidND
359719900MedicaidMN
81403MedicaidND
18765MedicaidND
81404MedicaidND
81406MedicaidND
81402MedicaidND
81405MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

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
I20101116001132 MN Practitioner - Diagnostic Radiology 4880889880 Reassigns benefits to 3 organizations
I20101118000689 ND Practitioner - Diagnostic Radiology 4880889880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Dakota School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center Fargo 1,210 clinicians

Practice addresses (Care Compare)

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

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 234-2000

201 4TH Ave
Enderlin, ND 58027-1325
Phone (701) 437-3320

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

2301 25TH St S
Fargo, ND 58103-6104
Phone (701) 234-7400

2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000

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

3035 Demers Ave
Grand Forks, ND 58201-4040
Phone (701) 746-7521

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

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

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

69 Hwy 13 W
Gwinner, ND 58040-4127
Phone (701) 678-2263

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

904 5TH Ave NE
Jamestown, ND 58401-3437
Phone (701) 253-4000

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Sanford Thief River Falls Medical Center Hospital, Thief River Falls, MN, CCN 241381
  • Perham Health Hospital, Perham, MN, CCN 241373
  • Sanford Mayville Hospital, Mayville, ND, CCN 351309
  • Kittson Healthcare Hospital, Hallock, MN, CCN 241336

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 Health of Northern Minnesota Family Medicine Current Accepting new patients
Sanford Health of Northern Minnesota Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Sanford Medical Center Fargo CurrentSince Nov 1, 2014 Accepting new patients
Sanford Medical Center Fargo Family Medicine CurrentSince Nov 1, 2014 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Mar 1, 2020 Accepting new patients
Sanford Health Network North CurrentSince Mar 3, 2018 Accepting new patients
Sanford Health Network North CurrentSince Mar 3, 2018 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

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

621 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-5800

445 1st St E
Halstad, MN 56548
Phone (218) 456-2158

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

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

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

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

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

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

407 Washington Ave E
Finley, ND 58230
Phone (701) 524-1005

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

600 1st St SE
Mayville, ND 58257
Phone (701) 786-4500

42 6th Ave SE
Mayville, ND 58257
Phone (701) 786-3800

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

Organizations & group practices 9

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1386665503",
    "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",
            "telephone_number": "701-234-2000"
        },
        {
            "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": "701-234-2406",
            "fax_number": "701-234-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLMAN",
        "first_name": "DONALD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "7467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81407",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "359719900",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81403",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18765",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81404",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81406",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81402",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81405",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.