NPIMap

Individual provider Active NPI

Matthew James McLeod, MD

  • Family Medicine Physician
  • West Fargo, ND
National Provider Identifier
1477870681
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LT12948 Issued in ND
Practice address
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone
(701) 234-4445
NPI assigned
Apr 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X LT12948 ND Primary

Addresses

Primary practice location

1220 Sheyenne St
West Fargo, ND 58078-2637

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130910000414 ND Practitioner - Family Practice 3274704648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2010
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

4840 23Rd Ave S
Fargo, ND 58104-9136
Phone (701) 417-6999

Hospital & facility affiliations

  • Sanford Home Care Fargo Home health agency, Fargo, ND, CCN 357037
  • Hia Hospice Hospice, Fargo, ND, CCN 351500
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Pam Rehabilitation Hospital of Fargo Inpatient rehabilitation facility, Fargo, ND, CCN 353026
  • The Meadows on University Nursing home, Fargo, ND, CCN 355024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Removal or shaving of skin growth1-10

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 Aug 15, 2013 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 15, 2013 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients
Fargo Nursing and Rehab Center, LLC Past Accepting new patients

Locations

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 4

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 9

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": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1477870681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782637",
            "telephone_number": "701-234-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782637",
            "telephone_number": "701-234-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-27",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "LT12948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

Verify at the official NPI Registry.