Bhanu Odedra-Mistry, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9362 Issued in ND

Practice address

1707 Gold Dr S Ste 101
Fargo, ND 58103-6413

Phone

(701) 280-2033

Fax

(701) 232-5578

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Hospitalist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028
• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Internal Medicine Associates Inc

  • Internal Medicine Physician
  • Fargo, ND
  • NPI 1144313743
  Medicare reassignment NPD
• Sanford Medical Center Fargo

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  Internal Medicine

  Medicare reassignment NPD
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  NPD
• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1194742668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 GOLD DR S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036413",
            "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": "1707 GOLD DR S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036413",
            "telephone_number": "701-280-2033",
            "fax_number": "701-232-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEDRA-MISTRY",
        "first_name": "BHANU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "9362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney J Oberlander, CCC/SLP
• Brady Och
• Lauren Ochoa, MD
• Amy Lynn Ochsendorf, PSYD
• Amanda Ockert
• Bailey Ann Odegaard, OTR/L
• Deb Odegard, COTA/L
• Oluwatobi Ezekiel Odetola, MBBS
• Krista Lee Odili
• Megan Odland, OTR/L

• Internal Medicine Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Internal Medicine Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.

Verify at the official NPI Registry.