Lindsey Jo Dahl, M.D
Individual provider Active NPI Internal Medicine Physician · Fargo, ND
NPI 1962529446 · NPPES record last updated Jan 18, 2012
Key facts
- NPI
- 1962529446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 11583 (ND)
- Practice address
- 2400 32ND Ave S
Fargo, ND 58103-5800 - Phone
- (701) 234-8820
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Creighton University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000
Hospital & facility affiliations
- Sanford Home Care Fargo
- Ethos Home Health
- Hia Hospice
- Sanford Fargo Hospice
- Ethos Hospice
- Sanford Medical Center Fargo
- Perham Health
- Pam Rehabilitation Hospital of Fargo
- Fargo Elim Health Care Center
- Bethany on 42ND
- Eventide Fargo
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ND, 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 |
|---|---|---|---|---|
| I20101007000592 | ND | Practitioner - Internal Medicine | 9335200864 | Reassigns benefits to 1 organization |
| I20220305000137 | MN | Practitioner - Internal Medicine | 9335200864 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004015384 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Internal Medicine | Current |
Accepting new patients |
| Sanford Medical Center Fargo | Past | Accepting new patients | |
| Elim Homes, Inc | Past | Accepting new patients |
Locations
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2004015384 | MO | |
| Internal Medicine Physician | 207R00000X | 11583 | ND | Yes |
Addresses
Primary practice location
2400 32ND Ave S
Fargo, ND 58103-5800
Mailing address
2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-8820
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15367 | Medicaid | ND |
Other providers in Fargo, ND
- Jamie L Dahl
- Jeanette Kay Dahl
- Jonathan P Dahl
- Kayliana Dahl
- Kevin Dahl
- Megan Dahl
- Michell Dahl
- Natasha M Dahl
- Sonja Heide Dahl
- Tia Dahlen
All providers in Fargo, ND · Internal Medicine Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 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.