Sreejith Gopi, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12320 Issued in ND

Practice address

4110 51St Avenue South
Fargo, ND 58104

Phone

(701) 364-8915

NPI assigned

Jul 2, 2009

Last updated

Oct 7, 2016By the provider in NPPES

Sex

Male

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, MN2 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

Family Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridges Medical CenterGroup PAC ID 4981659851, shared by 3 NPIs, 22 clinicians

Innovis Health LLCGroup PAC ID 9931298155, shared by 7 NPIs, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Ada Hospital, Ada, MN, CCN 241313
• Essentia Health Hospital, Fargo, ND, CCN 350070

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Health Care Center

  • Federally Qualified Health Center (FQHC)
  • Fargo, ND
  • NPI 1710066352
  Medicare reassignment NPD
• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment NPD
• Bridges Medical Center

  dba Essentia Health Ada

  • Critical Access Hospital
  • Ada, MN
  • NPI 1306836598
  Medicare reassignment NPD
• Bridges Medical Center

  dba Essentia Health Ada Clinic

  • Rural Health Clinic/Center
  • Ada, MN
  • NPI 1366886186
  Medicare reassignment NPD
• Innovis Health LLC

  dba Essentia Health Moorhead Clinic

  • Family Medicine Physician
  • Moorhead, MN
  • NPI 1659617504
  Medicare reassignment NPD
• Innovis Health LLC

  dba Essentia Health-Osgood Clinic

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576

  Family Medicine

  NPD
• Innovis Health LLC

  dba Essentia Health Hankinson Clinic

  • Family Medicine Physician
  • Hankinson, ND
  • NPI 1750725743
  NPD
• Family Health Care Center

  dba Family HealthCare

  • Federally Qualified Health Center (FQHC)
  • Moorhead, MN
  • NPI 1992559645
  NPD

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

• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation
• Bridges Medical Center

  dba Essentia Health Ada

  • Critical Access Hospital
  • Ada, MN
  • NPI 1306836598
  Care Compare affiliation

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1275762924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 51ST AVENUE SOUTH",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-364-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPI",
        "first_name": "SREEJITH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "12320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Goodrun
• Goodsamaritan Home Care
• Holly Goodsell
• Goodwill Foundation Inc
• Stacy L Goodwill, D.D.S.
• Jena Gorden, MS CCC-SLP
• Arianna Nicole Gorder, SLP
• Beth Ann Gorder, HIS
• Kathryn Gordon, PHD
• Steven D Gordon, LADC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.