Individual provider Active NPI

Tiffany D Swenson, PA-C

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1619164654
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0403 Issued in ND
Practice address
5257 27TH St S Ste 201
Fargo, ND 58104-7782
Phone
(701) 356-5503
NPI assigned
Oct 3, 2007
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0403 ND Primary
Physician Assistant 363A00000X 10357 MN
Medical Physician Assistant 363AM0700X PAC0403 ND

Addresses

Primary practice location

5257 27TH St S Ste 201
Fargo, ND 58104-7782

Mailing address

5257 27TH St S Ste 201
Fargo, ND 58104-7782
Phone (701) 356-5503

Other identifiers 6

IdentifierTypeStateIssuer
0128334OtherMEDICA
30111OtherNDBCBS
HP84398OtherHEALTH PARTNERS
325452000MedicaidMN
PENDINGOtherMNMN BCBS
1053111OtherPREFERRED ONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071214000388 MN Practitioner - Physician Assistant 1850481805 Reassigns benefits to 2 organizations
I20081205000431 ND Practitioner - Physician Assistant 1850481805 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, shared by 7 NPIs, 561 clinicians
Altaire Clinic PLLCGroup PAC ID 5698103554, 5 clinicians

Practice addresses (Care Compare)

1401 13TH Ave E
West Fargo, ND 58078-3468
Phone (701) 364-5751

208 Oppegard Ave NW
Twin Valley, MN 56584-4038
Phone (218) 584-5181

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

3902 13TH Ave S
Suite 3704
Fargo, ND 58103-7512
Phone (701) 364-6600

4110 51St Ave S
Fargo, ND 58104-7776
Phone (701) 364-3100

4476 31St Ave S
Suite 101
Fargo, ND 58104-4532
Phone (701) 234-9400

4622 40TH Ave S
Suite a
Fargo, ND 58104-4394
Phone (701) 364-8900

5257 27TH St S
Suite 201
Fargo, ND 58104-7782
Phone (701) 356-5503

720 Main Ave
Moorhead, MN 56560-2752
Phone (218) 359-0399

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10357MNMDGeneral Practice Dentistry
PAC0403NDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Mar 21, 2011 Accepting new patients
Innovis Health LLC CurrentSince Mar 21, 2011 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 22, 2019 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 22, 2019 Accepting new patients
St Marys Regional Health Center CurrentSince Feb 23, 2026 Accepting new patients
Innovis Health LLC CurrentSince Jan 26, 2022 Accepting new patients
St Mary's Regional Health Center CurrentSince Feb 23, 2026 Accepting new patients
Tracie M Mallberg MD PC Past Accepting new patients
Apex Physical Therapy and Wellness Center, PC Past Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

414 W Jefferson Ave
Mahnomen, MN 56557
Phone (218) 935-2511

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

1103 1st St E
Park Rapids, MN 56470
Phone (218) 732-0542

208 Oppegard Ave NW
Twin Valley, MN 56584
Phone (218) 584-5181

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

1717 University Dr S
Fargo, ND 58103
Phone (701) 234-2305

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

2829 University Dr S
Ste 101
Fargo, ND 58103
Phone (701) 232-9000

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

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

1401 13th Ave E
West Fargo, ND 58078
Phone (701) 364-0060

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1619164654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 27TH ST S STE 201",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047782",
            "telephone_number": "701-356-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5257 27TH ST S STE 201",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047782",
            "telephone_number": "701-356-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "TIFFANY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0403",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10357",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0403",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0128334",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30111",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP84398",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325452000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BCBS",
            "identifier": "PENDING",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1053111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.