Active NPI
John Patrick Eickman, M.D.
- Neurological Surgery Physician
- Fargo, ND
National Provider Identifier
1114106820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 11568
- Practice address
- 2301 25TH St S
Fargo, ND 58103-6104 - Phone
- (701) 417-6130
- NPI assigned
- Oct 30, 2007
- Last updated
- Aug 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurological Surgery Physician | 207T00000X | 11568 | ND | Primary |
| Neurological Surgery Physician | 207T00000X | 56052 | MN |
Addresses
Primary practice location
2301 25TH St S
Fargo, ND 58103-6104
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other practice location 1
3035 DeMers Ave
Grand Forks, ND 58201-4040
Phone (701) 746-7521
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114106820 | Medicaid | MN |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- University of North Dakota School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 217 |
| Laminectomy or laminotomy (partial removal of spine bones) | 108 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11568 | ND | MD | Neurological Surgery Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grand Forks, ND
- NPI 1154346161
-
- Critical Access Hospital
- Cavalier, ND
- NPI 1760542500
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Hospital
-
dba Sanford Physical Therapy
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
dba Sanford Bemidji
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1114106820",
"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": "2301 25TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581036104",
"telephone_number": "701-417-6130"
}
],
"practiceLocations": [
{
"address_1": "3035 DeMers Ave",
"address_purpose": "LOCATION",
"city": "Grand Forks",
"state": "ND",
"postal_code": "582014040",
"country_code": "US",
"telephone_number": "701-746-7521",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EICKMAN",
"first_name": "JOHN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-30",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "ND",
"license": "11568",
"primary": true
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "MN",
"license": "56052",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1114106820",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.