Individual provider Active NPI

Suzanne Nigro, PA

  • Physician Assistant
  • Minot, ND
National Provider Identifier
1831279603
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0328 Issued in ND
Practice address
20 Burdick Expy W
Minot, ND 58701-4498
Phone
(701) 857-5877
Fax
(701) 857-5398
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0328 ND Primary

Addresses

Primary practice location

20 Burdick Expy W
Minot, ND 58701-4498

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5650

Other practice location 1

5015 Campuswood Dr Ste 107
East Syracuse, NY 13057-4236
Phone (315) 204-0397

Other identifiers 1

IdentifierTypeStateIssuer
12079MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028688NYMDPharmacist
PAC0328NDMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: snigro@landmarkhealth-direct.org
  • Direct secure messaging: ms_snigro2@landmarkhealth-direct.org

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1831279603",
    "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": "701-857-5650",
            "fax_number": "701-857-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BURDICK EXPY W",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014498",
            "telephone_number": "701-857-5877",
            "fax_number": "701-857-5398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5015 Campuswood Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "East Syracuse",
            "state": "NY",
            "postal_code": "130574236",
            "country_code": "US",
            "telephone_number": "315-204-0397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIGRO",
        "first_name": "SUZANNE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12079",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.