Individual provider Active NPI

Aileen L Luz, MD

  • Family Medicine Physician
  • Fargo, ND
National Provider Identifier
1801813571
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9203 Issued in ND
Practice address
2601 Broadway N
Fargo, ND 58102-6704
Phone
(701) 234-2900
Fax
(701) 234-2996
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41674 MN
Family Medicine Physician 207Q00000X 9203 ND Primary

Addresses

Primary practice location

2601 Broadway N
Fargo, ND 58102-6704

Mailing address

2601 Broadway N
Fargo, ND 58102-6704
Phone (701) 234-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151103001800 ND Order and Referring Only - Family PracticePractitioner - Family Practice 5890685804

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41674MNMDFamily Medicine Physician
9203NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Family Medicine Current Accepting new patients

Locations

2601 Broadway N
Fargo, ND 58102
Phone (701) 234-2482

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

420 S 7th St
Oakes, ND 58474
Phone (701) 742-3267

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1801813571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581026704",
            "telephone_number": "701-234-2900",
            "fax_number": "701-234-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581026704",
            "telephone_number": "701-234-2900",
            "fax_number": "701-234-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUZ",
        "first_name": "AILEEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "41674",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "9203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.