Active NPI
Brent Michael Buchholz, PA-C
- Physician Assistant
- Fargo, ND
National Provider Identifier
1619288305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PAC0428
- Practice address
- 2101 Elm St
Primary Care
Fargo, ND 58102 - Phone
- (701) 239-3700
- Fax
- (701) 451-7829
- NPI assigned
- Jun 28, 2010
- Last updated
- Mar 4, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0428 | ND | Primary |
Addresses
Primary practice location
2101 Elm St
Primary Care
Fargo, ND 58102
Mailing address
2101 Elm St
Primary Care
Fargo, ND 58102
Phone (701) 239-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1454980 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Francis Medical Center | Current | Accepting new patients |
Locations
3293 Solutions Ctr
Chicago, IL 60677
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Chi St Francis Health
- Rural Health Clinic/Center
- Milnor, ND
- NPI 1235215252
-
dba Fort Defiance Indian Hospital
- General Acute Care Hospital
- Fort Defiance, AZ
- NPI 1477876639
TX
-
- Critical Access Hospital
- Breckenridge, MN
- NPI 1891954574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1619288305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 ELM ST",
"address_2": "PRIMARY CARE",
"city": "FARGO",
"state": "ND",
"postal_code": "58102",
"telephone_number": "701-239-3700",
"fax_number": "701-451-7829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 ELM ST",
"address_2": "PRIMARY CARE",
"city": "FARGO",
"state": "ND",
"postal_code": "58102",
"telephone_number": "701-239-3700",
"fax_number": "701-451-7829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCHHOLZ",
"first_name": "BRENT",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-28",
"last_updated": "2025-03-04",
"certification_date": "2025-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ND",
"license": "PAC0428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1454980",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.