NPIMap

Individual provider Active NPI

Eric L Harry, PAC

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1861478745
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0577 Issued in SD
Practice address
1720 University Dr S
Fargo, ND 58103-4940
Phone
(701) 280-4140
NPI assigned
Dec 21, 2005
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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 0577 SD Primary

Addresses

Primary practice location

1720 University Dr S
Fargo, ND 58103-4940

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

8 E Hwy 12
Groton, SD 57445
Phone (605) 397-4242

Other identifiers 4

IdentifierTypeStateIssuer
4992827OtherSDWELLMARK BC/BS OF SD
6827442MedicaidSD
D24201053195OtherSDPREFERRED ONE
9238612OtherSDDAKOTACARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110406000566 ND Practitioner - Physician Assistant 9335104892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 234-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince May 19, 2011 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince May 19, 2011 Accepting new patients
Sanford Clinic North Past Accepting new patients
Avera St Luke's Past Accepting new patients
Avera St. Lukes Past Accepting new patients
Aberdeen Surgical Associates LLP Past Accepting new patients

Locations

1720 University Dr S
Fargo, ND 58103
Phone (701) 280-4140

2301 25th St SW
Fargo, ND 58103
Phone (701) 234-7400

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

801 Broadway N
Fargo, ND 58102
Phone (701) 234-2371

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

Organizations & group practices 7

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 5

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1861478745",
    "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",
            "fax_number": "605-397-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-280-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 E Hwy 12",
            "address_purpose": "LOCATION",
            "city": "Groton",
            "state": "SD",
            "postal_code": "57445",
            "country_code": "US",
            "telephone_number": "605-397-4242",
            "fax_number": "605-397-4243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRY",
        "first_name": "ERIC",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS OF SD",
            "identifier": "4992827",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6827442",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "D24201053195",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9238612",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.