NPIMap

Individual provider Active NPI

Andre Spence, M.D.

  • Internal Medicine Physician
  • Bagley, MN
National Provider Identifier
1861621153
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
104420 Issued in MN
Practice address
123 4TH St NW
Bagley, MN 56621-8306
Phone
(218) 694-2384
NPI assigned
Jul 8, 2009
Sex
Male
Sole proprietor
Yes

Organizations & group practices 22

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 22

Hospital & facility affiliations 13

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

View all 13

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health of Northern Minnesota 349 clinicians

Practice addresses (Care Compare)

1656 Central St W
Bagley, MN 56621-4357
Phone (218) 694-2384

Hospital & facility affiliations

  • Sanford Bemidji Home Care and Hospice Home health agency, Bemidji, MN, CCN 247215
  • Tru Healthcare, Inc Home health agency, Arden Hills, MN, CCN 248124
  • Sanford Bemidji Hospice Hospice, Bemidji, MN, CCN 241511
  • Hia Hospice Hospice, Fargo, ND, CCN 351500
  • Sanford Bagley Medical Center Hospital, Bagley, MN, CCN 241328
  • Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Cornerstone NSG & Rehab Center Nursing home, Bagley, MN, CCN 245307
  • Sanford Bagley Medical Center Nursing home, CCN 24Z328

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

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
I20090901000627 MN Practitioner - Internal Medicine 0941355622 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104420MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Mar 6, 2012 Accepting new patients
Sanford Health of Northern Minnesota Internal Medicine CurrentSince Mar 6, 2012 Accepting new patients
Sanford Health of Northern Minnesota Past Accepting new patients
Cornerstone Nursing and Rehab Center, Inc 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

22 Elm St
Clearbrook, MN 56634
Phone (218) 694-3124

22 Elm St
#67
Clearbrook, MN 56634
Phone (218) 776-3184

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 104420 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

123 4TH St NW
Bagley, MN 56621-8306

Mailing address

85 Grandeville Rd SW
Apt 912
Rochester, MN 55902-3579

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2009.

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1861621153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GRANDEVILLE RD SW",
            "address_2": "APT 912",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559023579"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "104420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bagley, MN

Sources for this page

Verify at the official NPI Registry.