NPIMap

Individual provider Active NPI

David P Fogarty, M.D.

  • Orthopaedic Surgery Physician
  • Duluth, MN
National Provider Identifier
1508823410
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
51578 Issued in MN
Practice address
1012 E 2ND St
Duluth, MN 55805-2200
Phone
(218) 249-6360
Fax
(218) 249-6370
NPI assigned
Apr 26, 2006
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 51578 MN Primary
Orthopaedic Surgery Physician 207X00000X MD22549 OR

Addresses

Primary practice location

1012 E 2ND St
Duluth, MN 55805-2200

Mailing address

1012 E 2ND St
Duluth, MN 55805-2200
Phone (218) 249-6360

Other identifiers 2

IdentifierTypeStateIssuer
288273MedicaidOR
200038407OtherORRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20090825000643 MN Practitioner - Orthopedic Surgery 3173413838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, San Diego School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

1120 E 34TH St
Hibbing, MN 55746-2909
Phone (218) 362-7100

4570 County Rd
Moose Lake, MN 55767-9401
Phone (218) 485-4724

8373 Unity Dr
Virginia, MN 55792-4005
Phone (218) 748-7480

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement26
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51578MNMDOrthopaedic Surgery Physician
MD22549ORMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Jun 6, 2009 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jun 6, 2009 Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1120 E 34th St
Hibbing, MN 55746
Phone (218) 263-7455

4791 County Road 10
Moose Lake, MN 55767
Phone (218) 249-5357

8373 Unity Dr
Virginia, MN 55792
Phone (218) 748-7421

Interoperability endpoints

  • Direct secure messaging: dfogarty237416@direct.aspirus.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1508823410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052200",
            "telephone_number": "218-249-6360",
            "fax_number": "218-249-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052200",
            "telephone_number": "218-249-6360",
            "fax_number": "218-249-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "51578",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD22549",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288273",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200038407",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "1012 E 2nd St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.