Christine S Brandt, PA-C
Individual provider Active NPI Physician Assistant · Fargo, ND
NPI 1669728929 · NPPES record last updated Jan 20, 2017
Key facts
- NPI
- 1669728929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PAC0489 (ND)
- Practice address
- 2400 32ND Ave S
Fargo, ND 58103-5800 - Phone
- (701) 234-8830
- NPI assigned
- Jul 24, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000
Hospital & facility affiliations
- Sanford Medical Center Fargo
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120904000731 | ND | Practitioner - Physician Assistant | 3173770740 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Past | Accepting new patients |
Locations
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
3955 56th St S
Ste D
Fargo, ND 58104
Phone (701) 234-2431
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PAC0489 | ND | |
| Physician Assistant | 363A00000X | PAC0489 | ND | Yes |
Addresses
Primary practice location
2400 32ND Ave S
Fargo, ND 58103-5800
Mailing address
2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-8830
Other providers in Fargo, ND
- Julie Braley
- Autumn Branca
- Brandan Anderson LTD
- Tammy Carol Branden
- Taylar Brandenburg
- Kristin Brandt
- Brinn Braton
- Morgan Braton
- Wendy Braton
- Cameron Bratz
All providers in Fargo, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.