Active NPI
Samuel T Feyder, PA-C
- Physician Assistant
- Crosby, MN
National Provider Identifier
1629550975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12829
- Practice address
- 320 East Main Street
Crosby, MN 56441 - Phone
- (218) 546-7000
- Fax
- (218) 546-4400
- NPI assigned
- Sep 4, 2018
- Last updated
- Jul 10, 2019
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MN | ||
| Physician Assistant | 363A00000X | 12829 | MN | Primary |
Addresses
Primary practice location
320 East Main Street
Crosby, MN 56441
Mailing address
320 East Main Street
Crosby, MN 56441
Phone (218) 546-7000
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: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cuyuna Regional Medical Center | Current | Accepting new patients | |
| Cuyuna Regional Medical Center | Current | Accepting new patients |
Locations
320 E Main St
Crosby, MN 56441
Phone (218) 546-7000
Organizations & group practices 3
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.
-
- Critical Access Hospital
- Crosby, MN
- NPI 1538143896
-
dba Longville Lakes Clinic
- Family Medicine Physician
- Longville, MN
- NPI 1861414518
-
- Critical Access Hospital Clinic/Center
- Crosby, MN
- NPI 1639459282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1629550975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 EAST MAIN STREET",
"city": "CROSBY",
"state": "MN",
"postal_code": "56441",
"telephone_number": "218-546-7000",
"fax_number": "218-546-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 EAST MAIN STREET",
"city": "CROSBY",
"state": "MN",
"postal_code": "56441",
"telephone_number": "218-546-7000",
"fax_number": "218-546-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEYDER",
"first_name": "SAMUEL",
"middle_name": "T",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-04",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "12829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crosby, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.