Individual provider Active NPI

Mary C Saunders, PA-C

  • Medical Physician Assistant
  • Fargo, ND
National Provider Identifier
1710909353
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAC0219 Issued in ND
Practice address
2801 University Dr S
Fargo, ND 58103-6029
Phone
(701) 234-5673
Fax
(701) 234-7195
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PAC0219 ND Primary

Addresses

Primary practice location

2801 University Dr S
Fargo, ND 58103-6029

Mailing address

PO Box 2168
Fargo, ND 58107-2168
Phone (701) 234-2119

Other identifiers 1

IdentifierTypeStateIssuer
71094MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101018000873 MN Practitioner - Physician Assistant 5799978177 Reassigns benefits to 2 organizations
I20101102000774 ND Practitioner - Physician Assistant 5799978177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 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

2801 University Dr S
Fargo, ND 58103-6029
Phone (701) 234-5673

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAC0219NDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jul 1, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 17, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 17, 2011 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

2603 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5222

2801 University Dr S
Fargo, ND 58103
Phone (701) 234-5673

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

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1710909353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581072168",
            "telephone_number": "701-234-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036029",
            "telephone_number": "701-234-5673",
            "fax_number": "701-234-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71094",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.