Justis Caldwell
Individual provider Active NPI Physician Assistant · Fargo, ND
NPI 1548023690 · NPPES record last updated Sep 9, 2024
Key facts
- NPI
- 1548023690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 321 8TH Ave N
Fargo, ND 58102-4550 - Phone
- (701) 234-2525
- NPI assigned
- Feb 1, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
21 Wiley Ave S
Lidgerwood, ND 58053-4001
Phone (701) 538-4189
321 8TH Ave N
Fargo, ND 58102-4550
Phone (701) 234-2525
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000
Hospital & facility affiliations
- Sanford Medical Center Fargo
- Perham Health
- Sanford Bemidji Medical Center
- Alomere Health
- Jamestown Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240918004922 | ND | Practitioner - Physician Assistant | 2769923663 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Past | Accepting new patients |
Locations
321 8th Ave N
Fargo, ND 58102
Phone (701) 234-2525
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
321 8TH Ave N
Fargo, ND 58102-4550
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
Other practice location 1
5535 18th St S
Fargo, ND 58104-6363
Phone (701) 928-0626
Other providers in Fargo, ND
- Brett Jessica Cadwell
- Deena C Caillier
- Rebecca Lee Caillier
- Jordan Cain
- Kenan Cain
- Joseph R Callahan
- Kevin C Callahan
- Jamie Marie Calloway
- Caitlyn R Cameron
- Kathryn M Cameron
All providers in Fargo, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.