NPIMap

Organization Active NPI

Internal Medicine Associates Inc

  • Internal Medicine Physician
  • Fargo, ND
National Provider Identifier
1144313743
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE ASSOCIATES INC
Practice address
4450 31St Ave S Ste 102
Fargo, ND 58104-4557
Phone
(701) 280-2033
Fax
(701) 232-5578
NPI assigned
Oct 2, 2006
Last updated
Apr 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Michael J Lillestol, MDNPI 1669427688
Title
President
Phone
(701) 280-2033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

4450 31St Ave S Ste 102
Fargo, ND 58104-4557

Mailing address

4450 31St Ave S Ste 102
Fargo, ND 58104-4557
Phone (701) 280-2033

Other identifiers 4

IdentifierTypeStateIssuer
11941MedicaidND
05595001OtherNDND BLUE SHIELD
162D7INOtherMNMN BLUE SHIELD
301713300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041004000768 ND Part B Supplier - Clinic/Group Practice 8527027879 Receives reassigned benefits from 20 practitioners
Practice locations: Fargo, ND

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D0408393Internal Medicine Associates4450 31St Ave S Suite 102, Fargo, ND 58104AccreditationAug 20, 2026

National Provider Directory

National Provider Directory

Locations

100 4th St S
Ste 604
Fargo, ND 58103

1707 Gold Dr S
Fargo, ND 58103
Phone (701) 280-2033

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1144313743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 102",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "701-280-2033",
            "fax_number": "701-232-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 102",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "701-280-2033",
            "fax_number": "701-232-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "LILLESTOL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-280-2033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11941",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BLUE SHIELD",
            "identifier": "05595001",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BLUE SHIELD",
            "identifier": "162D7IN",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301713300",
            "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 Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.