Active NPI
Richard Gary Mason, DPM
- Podiatrist
- Fort Totten, ND
National Provider Identifier
1902933401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 5901001579
- Practice address
- 3883 74TH St. N.E.
3883 74TH St. N.E.
Fort Totten, ND 58335-0309 - Phone
- (701) 766-1600
- Fax
- (701) 766-1645
- NPI assigned
- Feb 28, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 5901001579 | MI | Primary |
Addresses
Primary practice location
3883 74TH St. N.E.
3883 74TH St. N.E.
Fort Totten, ND 58335-0309
Mailing address
PO Box 309
3883 74TH St. N.E.
Fort Totten, ND 58335-0309
Phone (701) 766-1600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5901001579 | MI | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spirit Lake Tribe | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Spirit Lake Health Center
- Health Service Clinic/Center
- Fort Totten, ND
- NPI 1114472891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902933401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 309",
"address_2": "3883 74TH ST. N.E.",
"city": "FORT TOTTEN",
"state": "ND",
"postal_code": "583350309",
"telephone_number": "701-766-1600",
"fax_number": "701-766-1645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3883 74TH ST. N.E.",
"address_2": "3883 74TH ST. N.E.",
"city": "FORT TOTTEN",
"state": "ND",
"postal_code": "583350309",
"telephone_number": "701-766-1600",
"fax_number": "701-766-1645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "RICHARD",
"middle_name": "GARY",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "5901001579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Totten, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.