FERGUS FALLS MEDICAL GROUP, P.A. — NPI 1619915543 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in WHEATON, MN)

CMS-1500 Box 24J / 33a • NPI

1619915543

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261Q00000X (CMS 70)

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

403 12TH ST N, WHEATON, MN, 56296-1070

✓ 9-Digit EDI 837 ZIP+4 (56296-1070)

Practice Phone & Referral Fax

(320) 563-8295

Fax: (320) 563-8014

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1619915543 (FERGUS FALLS MEDICAL GROUP, P.A.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1619915543` (NPI-2 Organization / Facility)
Provider / Legal Name	FERGUS FALLS MEDICAL GROUP, P.A.
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261Q00000X` (Clinic/Center)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	403 12TH ST N, WHEATON, MN, 56296-1070
Practice Telephone / Fax	Tel: (320) 563-8295 \| Fax: (320) 563-8014
Administrative Mailing Address	615 S MILL ST, FERGUS FALLS, MN, 56537-2756
Enumeration & Last Sync	Enumerated: 2006-06-03 \| CMS Record Updated: 2018-08-17
Authorized Official	JIM WILKUS (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

403 12TH ST N, WHEATON, MN, 56296-1070

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Plain-English Taxonomy & CMS Crosswalk (261Q00000X)

What Does Taxonomy Code 261Q00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261Q00000X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 70 (Clinic or Group Practice)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (FERGUS FALLS MEDICAL GROUP, P.A.)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261Q00000X` — Clinic/Center Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: MN \| License: `44` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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FERGUS FALLS MEDICAL GROUP, P.A. (NPI #1619915543)