Sarah Jane Israelson, M.D.
Individual provider Active NPI Family Medicine Physician · Staples, MN
NPI 1922098581 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922098581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34532 (MN)
- Practice address
- 49725 County 83
Staples, MN 56479-5280 - Phone
- (218) 894-1515
- Fax
- (218) 894-1316
- NPI assigned
- Oct 25, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, ND
- 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 |
|---|---|---|---|---|
| I20031212000336 | MN | Practitioner - Family Practice | 3577471192 | Reassigns benefits to 1 organization |
| I20240208004432 | ND | Practitioner - Family Practice | 3577471192 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34532 | MN | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McKenzie County Healthcare Systems Inc | Current |
Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Family Medicine | Current | Accepting new patients |
| McKenzie County Healthcare Systems Inc | Family Medicine | Current |
Accepting new patients |
| Lakewood Health System | Current | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| Lakewood Health System | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Past | Accepting new patients |
Locations
1233 Highway 10 S
Motley, MN 56466
Phone (218) 352-6337
653 Pillsbury St N
Ste 1
Pillager, MN 56473
Phone (218) 746-4550
49725 County 83
Staples, MN 56479
Phone (218) 894-1033
1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010
709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331
525 N Main St
Watford City, ND 58854
Phone (701) 842-3771
1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470
Interoperability endpoints
- sisraelson654064@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34532 | MN | Yes |
Addresses
Primary practice location
49725 County 83
Staples, MN 56479-5280
Mailing address
49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515
Other providers in Staples, MN
- Michael Kenneth Hudalla
- Christopher Douglas Hughes
- Donald B Hughes
- Independent School District 2170
- Infinite Health Collaborative, PA
- Jan Johnson
- Jody Lynn Jenson
- Travis Marshall Johnson
- Barbara Kaneski I
- Brita Rose Karolus
All providers in Staples, 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 Jul 8, 2007. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.