Mark Tsibulsky, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

42279 Issued in MN

Practice address

120 Labree Ave S
Thief River Falls, MN 56701

Phone

(218) 683-4351

Fax

(218) 683-4362

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Psychiatry

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lifecare Medical Center Hospital, Roseau, MN, CCN 241344
• Sanford Thief River Falls Medical Center Hospital, Thief River Falls, MN, CCN 241381
• Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100
• Altru Hospital Hospital, Grand Forks, ND, CCN 350019

Merit-based Incentive Payment System (MIPS)

Final score

90.22 of 100Reported as group

Quality

90.28

Promoting interoperability

100

Improvement activities

40

Cost

72.7

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sanford Health Network North

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1386047355
  Medicare reassignment Care Compare group NPD
• Sanford Health Network North

  • Community/Retail Pharmacy
  • Thief River Falls, MN
  • NPI 1346423373
  NPD
• Sanford Health Network North

  • Rural Health Clinic/Center
  • Halstad, MN
  • NPI 1407882780
  NPD

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

• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Care Compare affiliation
• Sanford Health Network North

  • Critical Access Hospital
  • Thief River Falls, MN
  • NPI 1043218753
  Care Compare affiliation
• Sanford Health Network North

  • Psychiatric Hospital
  • Thief River Falls, MN
  • NPI 1790842466
  Care Compare affiliation
• Sanford Health Network North

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1861895906

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  • Rural Acute Care Hospital
  • Bemidji, MN
  • NPI 1801870191
  Care Compare affiliation
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1518915511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LABREE AVE S",
            "address_2": "NORTHWEST MEDICAL CENTER MENTAL HEALTH DIVISION",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "56701",
            "telephone_number": "218-683-4351",
            "fax_number": "218-683-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LABREE AVE S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "56701",
            "telephone_number": "218-683-4351",
            "fax_number": "218-683-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIBULSKY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "42279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "482402400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.