NPIMap

Individual provider Active NPI

Chetan P Maingi, MD

  • Dermatology Physician
  • Fargo, ND
National Provider Identifier
1952408809
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
10395 Issued in ND
Practice address
4556 40TH Avenue South
Suite 130
Fargo, ND 58104
Phone
(701) 234-8860
Fax
(701) 234-8924
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01052439A IN
Dermatology Physician 207N00000X 36007 AZ
Dermatology Physician 207N00000X 10395 ND Primary

Addresses

Primary practice location

4556 40TH Avenue South
Suite 130
Fargo, ND 58104

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061030000462 ND Practitioner - Dermatology 1254338551 Reassigns benefits to 1 organization
I20091223000443 MN Practitioner - Dermatology 1254338551 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Temple University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, 349 clinicians
Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

1656 Central St W
Bagley, MN 56621-4357

1720 Hwy 59 S
Thief River Falls, MN 56701-4331
Phone (218) 681-4747

4656 40TH Ave S
Fargo, ND 58104-4397

P O Box
Sioux Falls, SD 57117-5074

PO Box
Sioux Falls, SD 57117-5074

Hospital & facility affiliations

  • Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Sanford Thief River Falls Medical Center Hospital, Thief River Falls, MN, CCN 241381
  • Sanford Bagley Medical Center Hospital, Bagley, MN, CCN 241328

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

Merit-based Incentive Payment System (MIPS)

Final score
90.22 of 100Reported as group
Quality
90.28
Promoting interoperability
100
Improvement activities
40
Cost
72.7

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision51
Removal of skin lesions414
Removal or shaving of skin growth1-10
Skin biopsy251

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01052439AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Sanford Health Network North CurrentSince Feb 17, 2018 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jun 2, 2013 Accepting new patients
Sanford Health Network North Past Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

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

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

4656 40th Ave S
Fargo, ND 58104
Phone (701) 234-2431

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 8

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1952408809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4556 40TH AVENUE SOUTH",
            "address_2": "SUITE 130",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-234-8860",
            "fax_number": "701-234-8924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINGI",
        "first_name": "CHETAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01052439A",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "36007",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ND",
            "license": "10395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.