Nancy M Eastman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9637 Issued in MN

Practice address

4622 40TH Ave S
Fargo, ND 58104-4394

Phone

(701) 364-2909

Fax

(701) 364-9346

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Earth Indian Health CenterGroup PAC ID 1658367925, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• White Earth Indian Health Center

  • Federal Public Health Clinic/Center
  • Ogema, MN
  • NPI 1093761710

  TX

  Medicare reassignment Care Compare group
• Naytahwaush Health Center

  • Federal Public Health Clinic/Center
  • Mahnomen, MN
  • NPI 1740202308
  NPD
• Pine Point Health Station

  • Federal Public Health Clinic/Center
  • Ponsford, MN
  • NPI 1679587331
  NPD

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294444800000",
    "number": "1487715405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 4TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024539",
            "telephone_number": "701-234-6161",
            "fax_number": "701-234-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 40TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044394",
            "telephone_number": "701-364-2909",
            "fax_number": "701-364-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "NANCY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9637",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0342",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melissa Easter, MED, LAPC
• Eaton Dental, PLLC
• Dana Marie Eaton, DNP
• Matthew J. Eaton, DDS
• Gary Roland Ebel, CRNA
• Ebenezer Group Home

• Physician Assistant in Fargo, ND
• Providers in Fargo, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2011; 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.