Individual provider Active NPI

Caitlin L. Pandolfo, M.D.

  • Obstetrics & Gynecology Physician
  • Fargo, ND
National Provider Identifier
1629415294
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
14636 Issued in ND
Practice address
1111 Harwood Dr S
Fargo, ND 58104-4603
Phone
(701) 234-2700
NPI assigned
May 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 256163 MA
Obstetrics & Gynecology Physician 207V00000X 14636 ND Primary
Obstetrics & Gynecology Physician 207V00000X 62329 MN

Addresses

Primary practice location

1111 Harwood Dr S
Fargo, ND 58104-4603

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

3000 32nd Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

Other practice location 2

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170830001186 ND Practitioner - Obstetrics/Gynecology 9931331956 Reassigns benefits to 1 organization
I20211213001328 MN Practitioner - Obstetrics/Gynecology 9931331956 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256163MAMDObstetrics & Gynecology Physician
62329MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Aug 11, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 11, 2025 Accepting new patients
Sanford Medical Center Fargo Obstetrics & Gynecology Current Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients
Innovis Health, LLC Past Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

1111 Harwood Dr S
Fargo, ND 58104
Phone (701) 234-2700

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1629415294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HARWOOD DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044603",
            "telephone_number": "701-234-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 32nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581036132",
            "country_code": "US",
            "telephone_number": "701-364-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDOLFO",
        "first_name": "CAITLIN",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "256163",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "14636",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "62329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.