Individual provider Active NPI

Ira Paul Michaelson, MD

  • Gastroenterology Physician
  • Minot, ND
National Provider Identifier
1649261256
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
15083 Issued in ND
Practice address
2305 37TH Ave SW
Minot, ND 58701-7669
Phone
(701) 857-5000
NPI assigned
Nov 2, 2005
Last updated
May 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 44790 MA
Gastroenterology Physician 207RG0100X C151266 CA
Gastroenterology Physician 207RG0100X 15083 ND Primary

Addresses

Primary practice location

2305 37TH Ave SW
Minot, ND 58701-7669

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5000

Other practice location 1

400 Burdick Expy E
Minot, ND 58701-4768
Phone (701) 857-7389

Other practice location 2

47647 Caleo Bay Dr Ste 210
LA Quinta, CA 92253-8858
Phone (760) 771-1000

Other practice location 3

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 306-6890

Other practice location 4

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 306-6890

Other identifiers 1

IdentifierTypeStateIssuer
6184944MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

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
I20180525001678 ND Practitioner - Gastroenterology 7719933738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity HealthGroup PAC ID 7911816020, 292 clinicians

Practice addresses (Care Compare)

400 Burdick Expy E
Minot, ND 58701-4768
Phone (701) 418-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.05 of 100Reported as group
Quality
60.57
Promoting interoperability
98
Improvement activities
40
Cost
77.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy403
Upper gastrointestinal (GI) endoscopy for acid reflux332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C151266CAMDGastroenterology Physician
15083NDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health CurrentSince May 1, 2018 Accepting new patients
Trinity Health CurrentSince May 1, 2018 Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

1 Burdick Expy W
Minot, ND 58701
Phone (701) 857-5124

101 3rd Ave SW
Minot, ND 58701
Phone (701) 857-5286

2305 37th Ave SW
Minot, ND 58701
Phone (701) 418-8550

400 Burdick Expy E
Minot, ND 58701
Phone (701) 727-7000

Organizations & group practices 2

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 7

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1649261256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017669",
            "telephone_number": "701-857-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Burdick Expy E",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587014768",
            "country_code": "US",
            "telephone_number": "701-857-7389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47647 Caleo Bay Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "LA Quinta",
            "state": "CA",
            "postal_code": "922538858",
            "country_code": "US",
            "telephone_number": "760-771-1000",
            "fax_number": "760-771-9001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 Governors Ave",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "MA",
            "postal_code": "021551643",
            "country_code": "US",
            "telephone_number": "781-306-6890",
            "fax_number": "781-306-6895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 Governors Ave",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "MA",
            "postal_code": "021551643",
            "country_code": "US",
            "telephone_number": "781-306-6890",
            "fax_number": "781-306-6895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAELSON",
        "first_name": "IRA",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "44790",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C151266",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ND",
            "license": "15083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6184944",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.