Active NPI
Eric R Promersberger, MD
- Vascular & Interventional Radiology Physician
- Fargo, ND
National Provider Identifier
1669490264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 8354
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-5015
- Fax
- (701) 234-7332
- NPI assigned
- Jul 18, 2006
- 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 |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 8354 | ND | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | 44063 | MN |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-5015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101105000469 | ND | Practitioner - Vascular Surgery | 7012101892 | Reassigns benefits to 1 organization |
| I20140109001337 | MN | Practitioner - Interventional Radiology | 7012101892 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of North Dakota School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000
Hospital & facility affiliations
- Sanford Medical Center Fargo
- Sanford Thief River Falls Medical Center
- Perham Health
- Sanford Mayville
- Sanford Hillsboro
- Vibra Hospital of Fargo
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.99 of 100
- Quality
- 92.39
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.9
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 12 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44063 | MN | MD | Vascular & Interventional Radiology Physician |
| 8354 | ND | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health of Northern Minnesota | Current | Accepting new patients | |
| Sanford Health of Northern Minnesota | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Health of Northern Minnesota | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients |
Locations
1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020
1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481
4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200
5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
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.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
- Internal Medicine Physician
- Bemidji, MN
- NPI 1780628149
-
- Physical Therapy Clinic/Center
- Walker, MN
- NPI 1902261456
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Long Term Care Hospital
- Fargo, ND
- NPI 1508205741
Long-term care hospital
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": "1335916800000",
"number": "1669490264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-5015",
"fax_number": "701-234-7332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-5015",
"fax_number": "701-234-7332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROMERSBERGER",
"first_name": "ERIC",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2012-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "ND",
"license": "8354",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "MN",
"license": "44063",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.