NPIMap

Individual provider Active NPI

Molly M Ruebke

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1902586381
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC1012 Issued in ND
Practice address
2601 Broadway N
Fargo, ND 58102-1406
Phone
(701) 234-2900
NPI assigned
Jul 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PAC1012 ND
Physician Assistant 363A00000X PAC1012 ND Primary

Addresses

Primary practice location

2601 Broadway N
Fargo, ND 58102-1406

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 417-6000

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
I20231002003173 ND Practitioner - Physician Assistant 1153775606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2023
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

2601 Broadway N
Fargo, ND 58102-1406
Phone (701) 234-2900

Hospital & facility affiliations

  • Sanford Home Care Fargo Home health agency, Fargo, ND, CCN 357037
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

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

State licenses

LicenseStateTypeSpecialty
PAC1012NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 28, 2023 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 28, 2023 Accepting new patients
Sanford Bismarck CurrentSince Aug 28, 2023 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

225 N 7th St
Bismarck, ND 58501
Phone (701) 224-9471

2601 Broadway N
Fargo, ND 58102
Phone (701) 234-2482

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

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

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1902586381",
    "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": "2601 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021406",
            "telephone_number": "701-234-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 University Dr S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581034940",
            "country_code": "US",
            "telephone_number": "701-417-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUEBKE",
        "first_name": "MOLLY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ND",
            "license": "PAC1012",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC1012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.