Individual provider Active NPI

Megha Alla Mudireddy, MD

  • Family Medicine Physician
  • Grand Forks, ND
National Provider Identifier
1487399119
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PT23254 Issued in ND
Practice address
1750 47TH Ave S
Grand Forks, ND 58201-7595
Phone
(701) 757-8700
NPI assigned
Apr 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X PT23254 ND Primary

Addresses

Primary practice location

1750 47TH Ave S
Grand Forks, ND 58201-7595

Mailing address

1750 47TH Ave S
Grand Forks, ND 58201-7595
Phone (701) 757-8700

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
I20260107001584 ND Practitioner - Family Practice 1052787256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2024
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

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Altru Hospital Hospital, Grand Forks, ND, CCN 350019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PT23254NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Single Specialty CurrentSince Oct 24, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 24, 2025 Accepting new patients
Sanford Medical Center Fargo Single Specialty Current Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1750 47th Ave S
Grand Forks, ND 58201
Phone (701) 757-8700

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

Organizations & group practices 4

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 6

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": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1487399119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 47TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582017595",
            "telephone_number": "701-757-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 47TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582017595",
            "telephone_number": "701-757-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDIREDDY",
        "first_name": "MEGHA",
        "middle_name": "ALLA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "PT23254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.