Individual provider Active NPI

Amber Lee Neugebauer, DO

  • Emergency Medicine Physician
  • Fargo, ND
National Provider Identifier
1477040061
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S5031 Issued in TX
Practice address
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone
(701) 417-2575
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S5031 TX Primary

Addresses

Primary practice location

5225 23Rd Ave S
Fargo, ND 58104-7927

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

600 Elizabeth St # 9B
Corpus Christi, TX 78404-2235
Phone (361) 861-1864

Other names 1

  • Amber Lee Hartman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210930001860 ND Practitioner - Emergency Medicine 7113348830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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 Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Emergency Medicine CurrentSince Aug 9, 2021 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 9, 2021 Accepting new patients
Code 3 Emergency Physicians, PA Emergency Medicine Past Accepting new patients

Locations

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933

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

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1477040061",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 23RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047927",
            "telephone_number": "701-417-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Elizabeth St # 9B",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784042235",
            "country_code": "US",
            "telephone_number": "361-861-1864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEUGEBAUER",
        "first_name": "AMBER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S5031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "HARTMAN",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.