Bruce Mark Dahlman, MD
Individual provider Active NPI Family Medicine Physician · Crosby, MN
NPI 1922058866 · NPPES record last updated Feb 28, 2012
Key facts
- NPI
- 1922058866
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 27317 (MN)
- Practice address
- 20 E Main St
Crosby, MN 56441-1614 - Phone
- (218) 546-7000
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakewood Health Center
Practice addresses (Care Compare)
600 Main Ave S
Baudette, MN 56623-2855
Phone (218) 634-1655
Hospital & facility affiliations
- Lakewood Health Center
- Lakewood Health Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.39 of 100
- Quality
- 86.16
- Promoting interoperability
- 100
- Improvement activities
- 40
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040628000518 | MN | Practitioner - Family Practice | 3678559986 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27317 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakewood Health Center | Current |
Accepting new patients | |
| International Falls Memorial Hospital Association | Current |
Accepting new patients | |
| Lakewood Health Center | Current |
Accepting new patients | |
| Mille Lacs Health System | Current |
Accepting new patients | |
| International Falls Memorial Hospital Association | Current |
Accepting new patients | |
| Mille Lacs Health System | Current |
Accepting new patients |
Locations
600 Main Ave S
Birchdale, MN 56623
Phone (218) 634-1655
1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481
200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750
Interoperability endpoints
- brucedahlman@normd.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 27317 | MN | Yes |
Addresses
Primary practice location
20 E Main St
Crosby, MN 56441-1614
Mailing address
420 Village CT
Cambridge, MN 55008-2179
Phone (218) 628-1751
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870867300 | Medicaid | MN |
Other providers in Crosby, MN
- Cuyuna Regional Medical Center
- Cuyuna Regional Medical Center
- Cuyuna Regional Medical Center
- Cuyuna Regional Medical Center
- Cuyuna Regional Medical Center
- Christopher Rockwell Davis
- Courtenay E Deane
- Meredith Decent
- Melissa Joy Deseth
- Abby L Dingmann
All providers in Crosby, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2012. 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.