Altaire Clinic PLLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Legal business name

ALTAIRE CLINIC PLLC

Practice address

5257 27TH St S Ste 201
Fargo, ND 58104-7782

Phone

(701) 356-5503

NPI assigned

Feb 3, 2020

Last updated

Dec 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tamra A Schue, FNPNPI 1104065499

Title

Owner

Phone

(701) 388-6306

Specialties & licenses 1

Addresses

Other names 1

• Laser Renewal PLLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamra A Schue

  • Family Nurse Practitioner
  • Fargo, ND
  • NPI 1104065499
  Medicare reassignment Care Compare group NPD Authorized official
• Angela Ann Dolalie Kelsch, FNP-C

  • Family Nurse Practitioner
  • Fargo, ND
  • NPI 1558799189
  Medicare reassignment Care Compare group NPD
• Richard M Schue, NP

  • Nurse Practitioner
  • Fargo, ND
  • NPI 1962424523
  Medicare reassignment Care Compare group NPD
• Amanda J Kittelson, PA-C

  • Physician Assistant
  • Fargo, ND
  • NPI 1922329903
  Medicare reassignment Care Compare group
• Tiffany D Swenson, PA-C

  • Physician Assistant
  • Fargo, ND
  • NPI 1619164654
  Medicare reassignment Care Compare group
• Heidi M Olson-Fitzgerald, PAC

  • Physician Assistant
  • Fargo, ND
  • NPI 1528094943
  Medicare reassignment

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1730710229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 27TH ST S STE 201",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047782",
            "telephone_number": "701-356-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5257 27TH ST S STE 201",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047782",
            "telephone_number": "701-356-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAIRE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "SCHUE",
        "authorized_official_first_name": "TAMRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-388-6306",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laser Renewal PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Daniel Almquist, M.D.
• Roaa Alobaidi
• Augusto M Alonto, M.D.
• Lorena Ann Alonzo
• Waseem Altaf, MD
• Altendorf Counseling (Altendorf Counseling Center)
• John Gerard Altendorf, MED LPCC
• Kelsey Altendorf, LMSW
• Althoff Dental, PC (Southpointe Dental)
• Alexander J Althoff, DDS

• Procedural Dermatology Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Procedural Dermatology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.