Active NPI
Sina Koochakzadeh
- Otolaryngology Physician
- Minot, ND
National Provider Identifier
1154940674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- PT22874
- Practice address
- 2305 37TH Ave SW
Minot, ND 58701-7669 - Phone
- (701) 418-7530
- Fax
- (701) 418-7531
- NPI assigned
- Apr 14, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | PT22874 | ND | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2305 37TH Ave SW
Minot, ND 58701-7669
Mailing address
PO Box 5010
Minot, ND 58702-5010
Phone (701) 418-8000
Other practice location 1
1345 Center Drve Rm2-M228
Gainesville, FL 32610-0001
Phone (352) 273-5199
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
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
- Otolaryngology
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2305 37TH Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000
Hospital & facility affiliations
- Trinity Hospitals
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Health | Current | Accepting new patients | |
| Trinity Health | Current | Accepting new patients |
Locations
2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222
101 3rd Ave SW
Minot, ND 58701
Phone (701) 857-5286
2305 37th Ave SW
Minot, ND 58701
Phone (701) 418-8550
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Minot, ND
- NPI 1083653752
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Minot, ND
- NPI 1629636204
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Minot, ND
- NPI 1427103910
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Minot, ND
- NPI 1487804092
-
- General Acute Care Hospital
- Minot, ND
- NPI 1932359544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758672000000",
"number": "1154940674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5010",
"city": "MINOT",
"state": "ND",
"postal_code": "587025010",
"telephone_number": "701-418-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2305 37TH AVE SW",
"city": "MINOT",
"state": "ND",
"postal_code": "587017669",
"telephone_number": "701-418-7530",
"fax_number": "701-418-7531"
}
],
"practiceLocations": [
{
"address_1": "1345 Center Drve Rm2-M228",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "FL",
"postal_code": "326100001",
"country_code": "US",
"telephone_number": "352-273-5199",
"fax_number": "352-392-6781",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOOCHAKZADEH",
"first_name": "SINA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-14",
"last_updated": "2025-09-24",
"certification_date": "2025-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "ND",
"license": "PT22874",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1068.1",
"affiliationName": "Cobius Healthcare Solutions",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "2720 Dundee Rd # 302",
"city": "Northbrook",
"state": "IL",
"country_code": "US",
"postal_code": "600622609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.