Individual provider Active NPI

Beth A Mork, M.D.

  • Family Medicine Physician
  • Cloquet, MN
National Provider Identifier
1972685220
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44774 Issued in MN
Practice address
417 Skyline Blvd
Cloquet, MN 55720-1164
Phone
(218) 879-1271
Fax
(218) 879-8904
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44774 MN Primary

Addresses

Primary practice location

417 Skyline Blvd
Cloquet, MN 55720-1164

Mailing address

417 Skyline Blvd
Cloquet, MN 55720-1164
Phone (218) 879-1271

Other identifiers 3

IdentifierTypeStateIssuer
0118973OtherMNMEDICA
340K8KEOtherMNBLUES & FIRST PLAN
690955800MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041028000332 MN Practitioner - Family Practice 4183686561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

1700 University Ave W
Saint Paul, MN 55104-3727

Hospital & facility affiliations

  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44774MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Jun 5, 2020 Accepting new patients
Healtheast Medical Research Institute Family Medicine CurrentSince Oct 30, 2013 Accepting new patients
Fairview Health Services Family Medicine CurrentSince Jun 5, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 30, 2013 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast St. John'S Hospital Past Accepting new patients

Locations

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: bmork503671@fairview.direct-ci.com

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 1

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1972685220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201164",
            "telephone_number": "218-879-1271",
            "fax_number": "218-879-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201164",
            "telephone_number": "218-879-1271",
            "fax_number": "218-879-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORK",
        "first_name": "BETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "44774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0118973",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES & FIRST PLAN",
            "identifier": "340K8KE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690955800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.