Cassandra Jean Bommersbach
Individual provider Active NPI Women's Health Nurse Practitioner · Bemidji, MN
NPI 1821831629 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1821831629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Women's Health Nurse Practitioner 363LW0102X
- License
- 11693 (MN)
- Practice address
- 1233 34TH St NW
Bemidji, MN 56601-5112 - Phone
- (612) 807-8626
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Health of Northern Minnesota
Practice addresses (Care Compare)
1233 34TH St NW
Bemidji, MN 56601-5112
Phone (218) 333-5522
1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000
1656 Central St W
Bagley, MN 56621-4357
Phone (218) 694-2384
Hospital & facility affiliations
- Sanford Bemidji Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20240815002610 | MN | Practitioner - Nurse Practitioner | 3173061611 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health of Northern Minnesota | Current | Accepting new patients | |
| Sanford Health of Northern Minnesota | Current |
Accepting new patients | |
| Sanford Health of Northern Minnesota | Current |
Accepting new patients |
Locations
1656 Central St W
Bagley, MN 56621
Phone (218) 694-2384
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 11693 | MN | Yes |
| Family Nurse Practitioner | 363LF0000X | 11693 | MN |
Addresses
Primary practice location
1233 34TH St NW
Bemidji, MN 56601-5112
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other providers in Bemidji, MN
- William L Bock
- Charlotte Anne Bogotty
- Abbey Bohlman
- April Bohlman
- Musa Gokalp Bolkent
- Gretchen Lee Bonik
- Diane Jeanne Boomgaarden/Saar
- Booshke Mental Health Inc.
- Joy Boston
- Katlyn Bowman
All providers in Bemidji, MN · Women's Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2024. 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.