Individual provider Active NPI

Susan J Meland II, MD

  • Psychiatry Physician
  • Fergus Falls, MN
National Provider Identifier
1619930609
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
41395 Issued in MN
Practice address
712 South Cascade Street
Fergus Falls, MN 56537-2813
Phone
(218) 739-2221
Fax
(218) 739-6742
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 41395 MN Primary

Addresses

Primary practice location

712 South Cascade Street
Fergus Falls, MN 56537-2813

Mailing address

712 South Cascade Street
Fergus Falls, MN 56537-2813
Phone (218) 736-8000

Other identifiers 4

IdentifierTypeStateIssuer
940814200MedicaidMN
01019156OtherMNPREFERREDONE
38B84MEOtherMNBLUECROSS/BLUESHIELD
1520407OtherMNUBH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040814000207 MN Practitioner - Psychiatry 2466425897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8027MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince May 1, 2010 Accepting new patients
Lake Region Healthcare Corporation Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince May 8, 2017 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince May 1, 2010 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1619930609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 SOUTH CASCADE STREET",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372813",
            "telephone_number": "218-736-8000",
            "fax_number": "218-739-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 SOUTH CASCADE STREET",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372813",
            "telephone_number": "218-739-2221",
            "fax_number": "218-739-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELAND",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "41395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940814200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "01019156",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "38B84ME",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "1520407",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.