NPIMap

Individual provider Active NPI

John Mark Andrew Gingerich, MD

  • Family Medicine Physician
  • Rolla, ND
National Provider Identifier
1508425877
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PT20193 Issued in ND
Practice address
213 2ND Ave NE
Rolla, ND 58367-7153
Phone
(701) 477-3161
NPI assigned
Jun 11, 2019
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X PT20193 ND Primary

Addresses

Primary practice location

213 2ND Ave NE
Rolla, ND 58367-7153

Mailing address

213 2ND Ave NE
Rolla, ND 58367-7153
Phone (701) 477-3161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626001007 ND Practitioner - Family Practice 6800224395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presentation Medical CenterGroup PAC ID 5991764045, 11 clinicians

Practice addresses (Care Compare)

213 2ND Ave NE
Rolla, ND 58367-7153
Phone (701) 477-3161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PT20193NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presentation Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Presentation Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Presentation Medical Center Past 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.

Hospital & facility affiliations 9

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": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1508425877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 2ND AVE NE",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583677153",
            "telephone_number": "701-477-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 2ND AVE NE",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583677153",
            "telephone_number": "701-477-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINGERICH",
        "first_name": "JOHN MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "PT20193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, ND

Sources for this page

Verify at the official NPI Registry.