Individual provider Active NPI

Alexa Privratsky, PA

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1104596527
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0905 Issued in ND
Practice address
700 1St Ave S
Fargo, ND 58103-1802
Phone
(701) 234-4036
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0905 ND Primary

Addresses

Primary practice location

700 1St Ave S
Fargo, ND 58103-1802

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

4906 28th Ave S Apt 217
Fargo, ND 58104-9018
Phone (701) 333-8896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225001955 ND Practitioner - Physician Assistant 8921492406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

2301 25TH St S
Fargo, ND 58103-6104
Phone (701) 234-7400

2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100
  • CHI Mercy Health Hospital, Valley City, ND, CCN 351324

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Oct 11, 2021 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 11, 2021 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

2301 25th St SW
Fargo, ND 58103
Phone (701) 234-7400

700 1st Ave S
Fargo, ND 58103
Phone (701) 234-4023

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933

1720 University Dr S
Fargo, ND 58103
Phone (701) 280-4140

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 4

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 8

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1104596527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 1ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031802",
            "telephone_number": "701-234-4036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4906 28th Ave S Apt 217",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581049018",
            "country_code": "US",
            "telephone_number": "701-333-8896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIVRATSKY",
        "first_name": "ALEXA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.