NPIMap

Individual provider Active NPI

Khaled Samih Zreik, M.D.

  • Surgical Critical Care Physician
  • Fargo, ND
National Provider Identifier
1437320710
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
11246 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102
Phone
(701) 234-2305
NPI assigned
Mar 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 50591 MN
Surgery Physician 208600000X 11246 ND
Surgical Critical Care Physician 2086S0102X 11246 ND Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102

Mailing address

PO Box 2168
Fargo, ND 58107-2168
Phone (701) 234-2119

Other identifiers 1

IdentifierTypeStateIssuer
17587MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080723000186 MN Practitioner - General Surgery 6406929587 Reassigns benefits to 3 organizations
I20090818000837 ND Practitioner - General Surgery 6406929587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50591MNMDSurgery Physician
11246NDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network North CurrentSince Apr 17, 2019 Accepting new patients
Sanford Health Network North Current Accepting new patients
Sanford Health Network North Current Accepting new patients
Sanford Health Network North CurrentSince Feb 21, 2018 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 25, 2013 Accepting new patients
Sanford Medical Center Fargo Surgery CurrentSince Oct 25, 2013 Accepting new patients
Sanford Health Network North Current Accepting new patients
Sanford Health Network North CurrentSince Feb 21, 2018 Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

407 Washington Ave E
Finley, ND 58230
Phone (701) 524-1005

42 6th Ave SE
Mayville, ND 58257
Phone (701) 786-3800

600 1st St SE
Mayville, ND 58257
Phone (701) 786-4500

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1437320710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581072168",
            "telephone_number": "701-234-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58102",
            "telephone_number": "701-234-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZREIK",
        "first_name": "KHALED",
        "middle_name": "SAMIH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-14",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "50591",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "11246",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ND",
            "license": "11246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17587",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.