NPIMap

Individual provider Active NPI

Derek Weninger, PA-C

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1437786860
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0851 Issued in ND
Practice address
3000 32ND Ave S
Fargo, ND 58103-6132
Phone
(701) 364-8000
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0851 ND Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103-6132

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dweninger13891771@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201012001593 ND Practitioner - Physician Assistant 9739509878 Reassigns benefits to 1 organization
I20220610000574 MN Practitioner - Physician Assistant 9739509878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

Hospital & facility affiliations

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14073MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Oct 6, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 14, 2020 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 14, 2025 Accepting new patients
Innovis Health, LLC Current Accepting new patients
Innovis Health LLC CurrentSince Oct 6, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 14, 2025 Accepting new patients
First Care Medical Services CurrentSince Oct 6, 2025 Accepting new patients
First Care Medical Services CurrentSince Jan 1, 2026 Accepting new patients

Locations

323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

900 Hilligoss Blvd SE
Fosston, MN 56542
Phone (218) 435-1133

2301 25th St SW
Fargo, ND 58103
Phone (701) 234-7400

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

1720 University Dr S
Fargo, ND 58103
Phone (701) 280-4140

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

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

Interoperability endpoints

  • Direct secure messaging: dweninger13891771@direct.sanfordhealth.org

Organizations & group practices 8

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 6

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1437786860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENINGER",
        "first_name": "DEREK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0851",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dweninger13891771@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1720 University Dr S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581034940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.