NPIMap

Individual provider Active NPI

Hasitha Idangodage, MD

  • Family Medicine Physician
  • Minot, ND
National Provider Identifier
1114367356
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.1411045 Issued in IL
Practice address
1201 11TH Ave SW
Minot, ND 58701-4207
Phone
(701) 858-6778
Fax
(701) 858-6811
NPI assigned
Jul 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.1411045 IL Primary
Family Medicine Physician 207Q00000X RL12778 ND

Addresses

Primary practice location

1201 11TH Ave SW
Minot, ND 58701-4207

Mailing address

1201 11TH Ave SW
Minot, ND 58701-4207
Phone (701) 858-6778

Other practice location 1

101 E 9th St
Pana, IL 62557-1785
Phone (217) 562-2131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161019002404 IL Practitioner - Family Practice 0547492688 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pana Community Hospital Association 55 clinicians
Taylorville Memorial Hospital 13 clinicians
Decatur Memorial Hospital 173 clinicians

Practice addresses (Care Compare)

101 E 9TH St
Pana, IL 62557-1716
Phone (217) 562-6246

201 E Pleasant St
Taylorville, IL 62568-1562
Phone (217) 824-3331

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

241 W Weaver Rd
Suite 145B
Forsyth, IL 62535-9766
Phone (217) 876-5220

Hospital & facility affiliations

  • Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
  • Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339
  • Pana Community Hospital Hospital, Pana, IL, CCN 141341
  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148
  • Pana Community Hospital Nursing home, CCN 14Z341
  • Taylorville Memorial Hospital Nursing home, CCN 14Z339

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
73.88 of 100Reported as group
Quality
63.91
Improvement activities
40
Cost
77.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.1411045ILMDFamily Medicine Physician
RL12778NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Taylorville Memorial Hospital CurrentSince Mar 31, 2024 Accepting new patients
Pana Community Hospital Association CurrentSince Dec 1, 2025 Accepting new patients
Pana Community Hospital Association Family Medicine CurrentSince Sep 2, 2023 Accepting new patients
Taylorville Memorial Hospital CurrentSince Mar 31, 2024 Accepting new patients
Decatur Memorial Hospital CurrentSince Aug 24, 2016 Accepting new patients
Decatur Memorial Hospital Family Medicine CurrentSince Aug 24, 2016 Accepting new patients
Pana Community Hospital Association CurrentSince Sep 2, 2023 Accepting new patients

Locations

2300 N Edward St
Ste 3200
Decatur, IL 62526
Phone (217) 876-3660

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

101 E 9th St
Pana, IL 62557
Phone (217) 562-2131

201 E Pleasant St
Taylorville, IL 62568
Phone (217) 707-5555

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 6

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1114367356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014207",
            "telephone_number": "701-858-6778",
            "fax_number": "701-858-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014207",
            "telephone_number": "701-858-6778",
            "fax_number": "701-858-6811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Pana",
            "state": "IL",
            "postal_code": "625571785",
            "country_code": "US",
            "telephone_number": "217-562-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDANGODAGE",
        "first_name": "HASITHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.1411045",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL12778",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.