Individual provider Active NPI

Ender G Raghib, M.D.

  • Pediatrics Physician
  • Fargo, ND
National Provider Identifier
1629155643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9514 Issued in ND
Practice address
3290 20TH St S Ste a
Fargo, ND 58104-5923
Phone
(701) 478-4722
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9514 ND Primary

Addresses

Primary practice location

3290 20TH St S Ste a
Fargo, ND 58104-5923

Mailing address

325 Edgewater Dr
West Fargo, ND 58078-4248
Phone (701) 364-2647

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
I20040107000723 ND Practitioner - Pediatric Medicine 6709785850 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9514NDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie County Healthcare Systems Inc CurrentSince Jun 10, 2024 Accepting new patients
Pinnacle Health Care, PLLC Pediatrics Current Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Jun 10, 2024 Accepting new patients
McKenzie County Healthcare Systems Inc Pediatrics Current Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
Pediatric Arts Clinic Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Pediatrics Past Accepting new patients

Locations

1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010

525 N Main St
Watford City, ND 58854
Phone (701) 842-3771

709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331

1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629155643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 EDGEWATER DR",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580784248",
            "telephone_number": "701-364-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 20TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045923",
            "telephone_number": "701-478-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHIB",
        "first_name": "ENDER",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ND",
            "license": "9514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.