Dustin J. Nowotny, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18674 Issued in ND

Practice address

3000 32ND Ave S
Fargo, ND 58103-6132

Phone

(701) 364-8000

NPI assigned

Jun 23, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Midwestern University College of Dental Medicine, Downers Grove, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Hospital, Fargo, ND, CCN 350070

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment Care Compare group NPD
• First Care Medical Services

  dba Essentia Health Fosston Clinic

  • Critical Access Hospital Clinic/Center
  • Fosston, MN
  • NPI 1073638565
  Medicare reassignment NPD
• First Care Medical Services

  dba Essentia Health Fosston

  • Critical Access Hospital
  • Fosston, MN
  • NPI 1497850119
  Medicare reassignment NPD
• St. Marys Regional Health Center

  dba Essentia Health St. Mary's- Detroit Lakes

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Medicare reassignment NPD
• Innovis Health LLC

  dba Essentia Health-Osgood Clinic

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576
  NPD
• First Care Medical Services

  dba Essentia Health Oklee Clinic

  • Rural Health Clinic/Center
  • Oklee, MN
  • NPI 1174812465
  NPD
• Innovis Health LLC

  dba Essentia Health Moorhead Clinic

  • Family Medicine Physician
  • Moorhead, MN
  • NPI 1659617504
  NPD
• St Mary'S Regional Health Center

  dba Essentia Health Park Rapids Clinic

  • Rural Health Clinic/Center
  • Park Rapids, MN
  • NPI 1699955344
  NPD
• St Mary'S Regional Health Center

  dba Essentia Health St. Mary's-Frazee Clinic

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1669992384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWOTNY",
        "first_name": "DUSTIN",
        "middle_name": "J.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "18674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Killian Norton, PA-C
• Margo R Norton, PHD
• Ali Novin, MD
• Carrolee Nowacki
• Melodee S Nowatzki, M.S.
• Ernest Sunjo Nsawir
• Innocent Nsengiyumva
• Sifa Ntivu Bisimwa
• Haley Nudell
• Sommer Rae Wild Nurkic, M.D., M.P.H.

• Surgery Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.

Verify at the official NPI Registry.