Jill Lesly Baldwin, PA-C
Individual provider Active NPI Physician Assistant · Fergus Falls, MN
NPI 1720038029 · NPPES record last updated Apr 29, 2022
Key facts
- NPI
- 1720038029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 11089 (MN)
- Practice address
- 712 S Cascade St
Fergus Falls, MN 56537-2913 - Phone
- (701) 538-4839
- NPI assigned
- May 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of North Dakota School of Medicine, 1998
- 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
21 Wiley Ave S
Lidgerwood, ND 58053-4001
Phone (701) 538-4189
Hospital & facility affiliations
- St Francis Medical Center
- Sanford Medical Center Fargo
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, 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 |
|---|---|---|---|---|
| I20120718000585 | MN | Practitioner - Physician Assistant | 5193981256 | Reassigns benefits to 1 organization |
| I20200219001176 | ND | Practitioner - Physician Assistant | 5193981256 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11089 | MN | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | 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
712 S Cascade St
Fergus Falls, MN 56537
4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11089 | MN | Yes |
| Physician Assistant | 363A00000X | PAC0203 | ND |
Addresses
Primary practice location
712 S Cascade St
Fergus Falls, MN 56537-2913
Mailing address
712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (701) 538-4839
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbaldwin14322294@direct.sanfordhealth.org |
Other providers in Fergus Falls, MN
- Joyce Jean Arndt
- Ricardo P. Ascano
- Wesley Asheim
- Stephen D Asp
- Jenee Babic
- Jill Marie Balgaard
- Jillene Marie Bantau
- Megan Barker
- Margaret M Barnes
- Steven Alan Bateman
All providers in Fergus Falls, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2022. 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.