John Mark Andrew Gingerich, MD
Individual provider Active NPI Family Medicine Physician · Rolla, ND
NPI 1508425877 · NPPES record last updated Sep 27, 2023
Key facts
- NPI
- 1508425877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- PT20193 (ND)
- Practice address
- 213 2ND Ave NE
Rolla, ND 58367-7153 - Phone
- (701) 477-3161
- NPI assigned
- Jun 11, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Presentation Medical Center
Practice addresses (Care Compare)
213 2ND Ave NE
Rolla, ND 58367-7153
Phone (701) 477-3161
Hospital & facility affiliations
- Tri Care Home Health, Inc.
- Presentation Medical Center
- Trinity Hospitals
- Presentation Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240626001007 | ND | Practitioner - Family Practice | 6800224395 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT20193 | ND | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presentation Medical Center | Current |
Accepting new patients | |
| Presentation Medical Center | Current |
Accepting new patients | |
| Presentation Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | PT20193 | ND | Yes |
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
Other providers in Rolla, ND
- Kodi Lynn Decoteau
- Alaina M Demers
- Lisa Marie Desjarlais
- Chasity Dixon
- Rachelle Long Fischer
- Tanya Jeanne Halone
- Haddi Hamley
- Lisa Hoffman
- Hayden M Jeanotte
- Pamela Kaleva
All providers in Rolla, ND · Family Medicine Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.