Individual provider Active NPI

Naomi Destaffany Schmid, D.P.M.

  • Podiatrist
  • Fergus Falls, MN
National Provider Identifier
1831401058
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901002372 Issued in MI
Practice address
615 S Mill St
Fergus Falls, MN 56537-2756
Phone
(218) 739-4447
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901002372 MI Primary

Addresses

Primary practice location

615 S Mill St
Fergus Falls, MN 56537-2756

Mailing address

615 S Mill St
Fergus Falls, MN 56537-2756
Phone (218) 739-4447

Other names 1

  • Naomi Jo Destaffany Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130529000390 MN Practitioner - Podiatry 7517105760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
892MNMDMarriage & Family Therapist
5901002372MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Aug 1, 2013 Accepting new patients
Lake Region Healthcare Corporation Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Aug 1, 2013 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Apr 19, 2020 Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Organizations & group practices 4

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": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1831401058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S MILL ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372756",
            "telephone_number": "218-739-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S MILL ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372756",
            "telephone_number": "218-739-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMID",
        "first_name": "NAOMI",
        "middle_name": "DESTAFFANY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901002372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAOMI",
            "last_name": "DESTAFFANY",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.