NPIMap

Individual provider Active NPI

Ram Prasad Paneru, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bagley, MN
National Provider Identifier
1740457902
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
51422 Issued in MN
Practice address
123 4TH St NW
Bagley, MN 56621-8306
Phone
(218) 694-2384
Fax
(218) 694-6687
NPI assigned
May 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12193 ND
Family Medicine Physician 207Q00000X 51422 MN
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 51422 MN Primary

Addresses

Primary practice location

123 4TH St NW
Bagley, MN 56621-8306

Mailing address

123 4TH St NW
Bagley, MN 56621-8306
Phone (218) 694-6501

Other identifiers 4

IdentifierTypeStateIssuer
1740457902MedicaidMN
P01201779OtherMNRR MEDICARE
P01204945OtherMNRR MEDICARE
P01201785OtherMNRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090312000344 MN Practitioner - Emergency MedicinePractitioner - Family Practice 7719043926 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverview Healthcare Association 46 clinicians

Practice addresses (Care Compare)

323 S Minnesota St
Crookston, MN 56716-1601
Phone (218) 281-9200

Hospital & facility affiliations

  • Riverview Hospital Hospital, Crookston, MN, CCN 241320
  • Altru Hospital Hospital, Grand Forks, ND, CCN 350019
  • Riverview Hospital Nursing home, CCN 24Z320

Merit-based Incentive Payment System (MIPS)

Final score
88.91 of 100Reported as group
Quality
88.07
Promoting interoperability
100
Improvement activities
40
Cost
74.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Family Medicine Current Accepting new patients
Riverview Healthcare Association CurrentSince Feb 8, 2013 Accepting new patients
Riverview Healthcare Association Current Accepting new patients
Sanford Health of Northern Minnesota Family Medicine CurrentSince Jun 7, 2013 Accepting new patients
Riverview Healthcare Association CurrentSince Feb 8, 2013 Accepting new patients
Sanford Health Network Family Medicine Current Accepting new patients
Sanford Health of Northern Minnesota Family Medicine Current Accepting new patients
Sanford Health Network CurrentSince Mar 1, 2009 Accepting new patients
St Joseph'S Area Health Services Past Accepting new patients
Northland Family Physicians LLC PastSince Sep 15, 2019 Accepting new patients
Aurora Urgent Care LLC PastSince Oct 1, 2006 Accepting new patients
Presentation Medical Center Past Accepting new patients

Locations

203 4th St NW
Bagley, MN 56621
Phone (218) 694-3939

1656 Central St W
Bagley, MN 56621
Phone (218) 694-2384

123 4th St NW
Bagley, MN 56621
Phone (218) 694-2384

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

323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200

1430 North Hwy
Jackson, MN 56143
Phone (507) 847-2200

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

600 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-3311

249 5th St E
Tracy, MN 56175
Phone (507) 629-3520

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1740457902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 4TH ST NW",
            "city": "BAGLEY",
            "state": "MN",
            "postal_code": "566218306",
            "telephone_number": "218-694-6501",
            "fax_number": "218-694-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 4TH ST NW",
            "city": "BAGLEY",
            "state": "MN",
            "postal_code": "566218306",
            "telephone_number": "218-694-2384",
            "fax_number": "218-694-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANERU",
        "first_name": "RAM",
        "middle_name": "PRASAD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "12193",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "51422",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MN",
            "license": "51422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740457902",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01201779",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01204945",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01201785",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bagley, MN

Sources for this page

Verify at the official NPI Registry.