USMAN ALI M.D
NPI 1245612084
Hospitalist in Fargo, ND

Active since June 28, 2015PECOS EnrolledAccepts Medicare Assignment
85.99/100
CMS Quality Rating
5225 23RD AVE S, FARGO, ND 58104(701) 417-2575 Get Directions Write a Review

NPPES record last updated: July 17, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 17, 2024, Apr 15, 2024, Dec 28, 2022 (3 updates tracked since 2022).

About Usman Ali M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

USMAN ALI M.D (NPI 1245612084) is an individual hospitalist provider in Fargo, North Dakota, licensed in North Dakota (20637) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Ascension Sacred Heart Bay, and maintains a secondary practice location in Pontiac.

NPPES Registry Identity

NPI1245612084
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameUSMAN ALICredential: M.D
Location Address5225 23RD AVE SFargo, ND 58104-7927
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJune 28, 2015
Last NPPES UpdateJuly 17, 20243 updates tracked since enumeration
NPPES CertifiedJuly 17, 2024
✔ NPI 1245612084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in ND · 20637
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License ME149652 (FL), 4301107109 (MI)
5225 23RD AVE S, Fargo, ND 58104

Secondary Practice Location 1

Location 144405 Woodward AvePontiac, MI 48341-5023 · Phone (248) 858-6233

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Usman Ali M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991004467
PECOS Enrollment IDI20240812000401
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Usman Ali reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Family Medicine
1220 SHEYENNE ST
West Fargo, ND 58078
  • Reassigned Medicare billing, North Dakota enrollment
  • 1,464 clinicians in this Medicare group
Internal Medicine
705 DIXIE ST
Carrollton, GA 30117
  • Reassigned Medicare billing, Georgia enrollment
  • 335 clinicians in this Medicare group
Internal Medicine
2001 KINGSLEY AVE
Orange Park, FL 32073
  • Reassigned Medicare billing, Florida enrollment
  • 903 clinicians in this Medicare group
Hospitalist
951 N WASHINGTON AVE
Titusville, FL 32796
  • Reassigned Medicare billing, Florida enrollment
  • 160 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
399 services158 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
389 services174 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
177 services169 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
84 services77 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
19 services17 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Sacred Heart Bay

Acute Care Hospitals · Panama City, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100026
Location615 N Bonita AvePanama City, FL 32401 · Bay County
Emergency services

Sanford Medical Center Fargo

Acute Care Hospitals · Fargo, ND
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number350011
Location801 Broadway NorthFargo, ND 58122 · Cass County
Emergency services Birthing friendly

Prairie Lakes Healthcare System, Inc

Acute Care Hospitals · Watertown, SD
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430005
Location401 9th Avenue NW Post Office Box 1210Watertown, SD 57201 · Codington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.45 typical visit price
range $55.75 – $168.12
Typical copayment $31.86 (range $13.93 – $42.03)
Most-billed visit code 99204
Established Patient
$98.29 typical visit price
range $18.11 – $137.65
Typical copayment $24.57 (range $4.52 – $34.41)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.98
Improvement Activities40
Cost80.63

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$16.47 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers26 claims26 services$81.59 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$30.98 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Emergency Medicine
5225 23RD AVE S
FARGO, ND 58104
Emergency Medicine
5225 23RD AVE S
FARGO, ND 58104
Internal Medicine
5225 23RD AVE S
FARGO, ND 58104
Hospitalist
5225 23RD AVE S
FARGO, ND 58104
Nurse Anesthetist, Certified Registered
5225 23RD AVE S
FARGO, ND 58104
Obstetrics & Gynecology
5225 23RD AVE S
FARGO, ND 58104
Nurse Anesthetist, Certified Registered
5225 23RD AVE S
FARGO, ND 58104
Nurse Practitioner
5225 23RD AVE S
FARGO, ND 58104

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Usman Ali's NPI number?

The NPI number for Usman Ali is 1245612084. It was assigned to this individual provider in the NPPES registry on June 28, 2015.

Where is Usman Ali located?

Usman Ali practices at 5225 23rd Ave S, Fargo, ND 58104. The listed phone number is (701) 417-2575.

What is Usman Ali's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Usman Ali enrolled in Medicare?

Yes. Usman Ali is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Usman Ali's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Usman Ali reassigns Medicare benefits to 4 organizations: Sanford Medical Center Fargo (West Fargo, ND), Apogee Medical Group, Georgia, Inc. (Carrollton, GA), Inpatient Consultants Of Florida, Inc (Orange Park, FL) and Apogee Medical Group, Florida, Inc. (Titusville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Usman Ali's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Usman Ali accept?

Health plans from Blue Cross Blue Shield of North Dakota, Oscar Health and Oscar Insurance Company list Usman Ali as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Usman Ali affiliated with any hospitals?

According to CMS data, Usman Ali is affiliated with Ascension Sacred Heart Bay, Sanford Medical Center Fargo and Prairie Lakes Healthcare System, Inc.

When was this NPI record last updated?

The NPPES record for Usman Ali was last updated on July 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.