Individual provider Active NPI

Ashwini Bharadwaj Vijayakumar, MD

  • Surgery Physician
  • Williston, ND
National Provider Identifier
1487140042
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
PT24430 Issued in ND
Practice address
1301 15TH Ave W
Williston, ND 58801-3821
Phone
(701) 774-7401
NPI assigned
Jul 7, 2018
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X PT24430 ND Primary

Addresses

Primary practice location

1301 15TH Ave W
Williston, ND 58801-3821

Mailing address

1301 15TH Ave W
Williston, ND 58801-3821
Phone (701) 774-7401

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260615002995 ND Practitioner - General Surgery 2961865274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1301 15TH Ave W
Williston, ND 58801-3821

4265 45TH St S
Suite 200
Fargo, ND 58104-4309

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PT24430NDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates, P.C. PastSince Sep 10, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1487140042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYAKUMAR",
        "first_name": "ASHWINI",
        "middle_name": "BHARADWAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-07",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "PT24430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.