Individual provider Active NPI

Peter Michael Fliss, D.O.

  • Interventional Pain Medicine Physician
  • Bemidji, MN
National Provider Identifier
1811308828
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
65728 Issued in MN
Practice address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone
(218) 333-5000
Fax
(218) 333-5360
NPI assigned
May 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X T-2795 MS
Interventional Pain Medicine Physician 208VP0014X 65728 MN Primary

Addresses

Primary practice location

1300 Anne St NW
Bemidji, MN 56601-5103

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (601) 984-5914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20190930002407 MN Practitioner - Pain Management 7719203900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.56 of 100Reported as group
Quality
74.25
Promoting interoperability
100
Improvement activities
40
Cost
76.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2795MSMDAnesthesiology Physician
65728MNMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota CurrentSince Aug 12, 2019 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota Anesthesiology CurrentSince Aug 12, 2019 Accepting new patients

Locations

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

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

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

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

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1811308828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "601-984-5914",
            "fax_number": "601-984-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-333-5000",
            "fax_number": "218-333-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLISS",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "T-2795",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MN",
            "license": "65728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.