NPIMap

Individual provider Active NPI

Mandy Lea Sorlie, MD

  • Family Medicine Physician
  • Jamestown, ND
National Provider Identifier
1649478090
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11582 Issued in ND
Practice address
904 5TH Ave NE
Jamestown, ND 58401-3437
Phone
(701) 253-4020
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 11013734A IN
Family Medicine Physician 207Q00000X 11582 ND Primary

Addresses

Primary practice location

904 5TH Ave NE
Jamestown, ND 58401-3437

Mailing address

904 5TH Ave NE
Jamestown, ND 58401-3437
Phone (701) 253-4020

Other identifiers 1

IdentifierTypeStateIssuer
11013734AOtherINMEDICAL RESIDENCY PERMIT

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
I20100908000250 ND Practitioner - Family Practice 0143385203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2007
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013734AINMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Family Medicine CurrentSince Oct 1, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 1, 2011 Accepting new patients
Lutheran Charity Association CurrentSince May 1, 2024 Accepting new patients
Lutheran Charity Association CurrentSince May 1, 2024 Accepting new patients
Lutheran Charity Association Past Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients
Memorial Hospital of South Bend 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

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

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

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1649478090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 5TH AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013437",
            "telephone_number": "701-253-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 5TH AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013437",
            "telephone_number": "701-253-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORLIE",
        "first_name": "MANDY",
        "middle_name": "LEA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "11013734A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "11582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL RESIDENCY PERMIT",
            "identifier": "11013734A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.