NPIMap

Individual provider Active NPI

Brad C Anderson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fargo, ND
National Provider Identifier
1649298381
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
46 Issued in ND
Practice address
2400 32ND Ave S
Fargo, ND 58103-5800
Phone
(701) 234-8720
Fax
(701) 234-8779
NPI assigned
Jul 18, 2006
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 673 MN
Podiatrist 213E00000X 46 ND
Foot & Ankle Surgery Podiatrist 213ES0103X 46 ND Primary

Addresses

Primary practice location

2400 32ND Ave S
Fargo, ND 58103-5800

Mailing address

PO Box 2010
Fargo, ND 58122-0605

Other identifiers 1

IdentifierTypeStateIssuer
11706MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address banderson1841166@direct.sanfordhealth.org

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
I20050322000683 ND Practitioner - Podiatry 2466407556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

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

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 234-2000

520 Chautauqua Blvd
Valley City, ND 58072-3145
Phone (701) 845-6000

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

904 5TH Ave NE
Jamestown, ND 58401-3437
Phone (701) 253-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.99 of 100Reported as group
Quality
92.39
Promoting interoperability
100
Improvement activities
40
Cost
70.9

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue54
Removal of skin lesions1-10
Removal of nail tissue380
Removal or shaving of skin growth206
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
673MNMDPodiatrist
46NDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Comprehensive Foot Centers P.a. Foot & Ankle Surgery Past Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1010 S Birch Ave
Hallock, MN 56728
Phone (218) 843-3612

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

1720 University Dr S
Fargo, ND 58103
Phone (701) 280-4140

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

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

Interoperability endpoints

  • Direct secure messaging: banderson1841166@direct.sanfordhealth.org

Organizations & group practices 4

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1649298381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035800",
            "telephone_number": "701-234-8720",
            "fax_number": "701-234-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRAD",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "673",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ND",
            "license": "46",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ND",
            "license": "46",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11706",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "banderson1841166@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1720 University Dr S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581034940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.