Active NPI
Jedidiah James Perkerewicz, M.D.
- Obstetrics & Gynecology Physician
- Detroit Lakes, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 54222
- Practice address
- 1245 Washington Ave
Detroit Lakes, MN 56501-3905 - Phone
- (218) 846-2000
- NPI assigned
- Jul 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 11956 | ND | |
| Obstetrics & Gynecology Physician | 207V00000X | 54222 | MN | Primary |
Addresses
Primary practice location
1245 Washington Ave
Detroit Lakes, MN 56501-3905
Mailing address
1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone (218) 846-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16234 | Medicaid | ND |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jperkerewicz1841876@direct.sanfordhealth.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- University of North Dakota School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- 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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11956 | ND | MD | Obstetrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
1245 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 846-2000
4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200
801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Interoperability endpoints
- jperkerewicz1841876@direct.sanfordhealth.org
Organizations & group practices 2
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.
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Obstetrics & Gynecology
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sanford Bemidji
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Hospital
-
dba Sanford Physical Therapy
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1548469208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 WASHINGTON AVE",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013905",
"telephone_number": "218-846-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1245 WASHINGTON AVE",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013905",
"telephone_number": "218-846-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERKEREWICZ",
"first_name": "JEDIDIAH",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-13",
"last_updated": "2022-04-29",
"certification_date": "2022-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "ND",
"license": "11956",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MN",
"license": "54222",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16234",
"state": "ND"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jperkerewicz1841876@direct.sanfordhealth.org",
"affiliation": "N",
"address_1": "1245 Washington Ave",
"city": "Detroit Lakes",
"state": "MN",
"country_code": "US",
"postal_code": "565013905",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.