NPIMap

Individual provider Active NPI

Stacy Roers Irmen, MD

  • Family Medicine Physician
  • Jamestown, ND
National Provider Identifier
1578723789
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11445 Issued in ND
Practice address
300 2ND Ave NE
Jamestown, ND 58401-3373
Phone
(701) 253-4020
Fax
(701) 323-5709
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11445 ND Primary

Addresses

Primary practice location

300 2ND Ave NE
Jamestown, ND 58401-3373

Mailing address

PO Box 2168
Fargo, ND 58107-2168
Phone (701) 234-2119

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
I20120912000149 ND Practitioner - Family Practice 6608024930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Lutheran Charity AssociationGroup PAC ID 2264341031, 168 clinicians

Practice addresses (Care Compare)

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

2422 20TH St SW
Jamestown, ND 58401-6201
Phone (701) 252-1050

300 2ND Ave NE
Jamestown, ND 58401-3373
Phone (701) 251-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
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

LicenseStateTypeSpecialty
11445NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jul 27, 2015 Accepting new patients
Lutheran Charity Association CurrentSince May 1, 2024 Accepting new patients
Sanford Medical Center Fargo Family Medicine CurrentSince Jul 27, 2015 Accepting new patients
Lutheran Charity Association CurrentSince May 1, 2024 Accepting new patients
Lutheran Charity Association Past Accepting new patients

Locations

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

300 2nd Ave NE
Jamestown, ND 58401
Phone (701) 251-6000

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

Organizations & group practices 5

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 8

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1578723789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581072168",
            "telephone_number": "701-234-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013373",
            "telephone_number": "701-253-4020",
            "fax_number": "701-323-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROERS IRMEN",
        "first_name": "STACY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "11445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.