Andrea M. Eickenbrock, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

12801 Issued in ND

Practice address

1380 S Columbia Rd - Altru Family Medicine Center
Grand Forks, ND 58201-4059

Phone

(701) 795-2000

Fax

(701) 795-2260

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Andrea Marie Feltman Former name

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

University of North Dakota School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altru Health SystemGroup PAC ID 1355251604, shared by 14 NPIs, 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Altru Health System

  • Clinic/Center
  • Crookston, MN
  • NPI 1760494330
  Medicare reassignment NPD
• Altru Health System

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Altru Health System

  • Rural Health Clinic/Center
  • Greenbush, MN
  • NPI 1962591438
  NPD
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  NPD (past)
• Clinic Pharmacy Inc

  • Community/Retail Pharmacy
  • Devils Lake, ND
  • NPI 1184718876
  NPD (past)

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

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1093943656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014032",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 S COLUMBIA RD - ALTRU FAMILY MEDICINE CENTER",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014059",
            "telephone_number": "701-795-2000",
            "fax_number": "701-795-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICKENBROCK",
        "first_name": "ANDREA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "R71437",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "12801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18826",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "FELTMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jules Efta, DC
• Laney Eggers
• Katie M Eggl, MS OTR/L
• Nicole Egstad
• Nathaniel Walker Ehlers
• Hunter Eickhoff
• Dawn M Eickman, PT
• Jeffrey J Eickman, MD
• Lawrence E Eickman, PT
• Amy J Elbert, PT

• Obstetrics & Gynecology Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Obstetrics & Gynecology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.