NPIMap

Individual provider Active NPI

Amanda J Pratt, PA-C

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1922353275
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0487 Issued in ND
Practice address
1702 University Dr S
Fargo, ND 58103-4940
Phone
(701) 364-3300
Fax
(701) 364-8906
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 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 PAC0487 ND Primary

Addresses

Primary practice location

1702 University Dr S
Fargo, ND 58103-4940

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other identifiers 1

IdentifierTypeStateIssuer
71077MedicaidND

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
I20121008000572 ND Practitioner - Physician Assistant 9335398346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

2801 University Dr S
Fargo, ND 58103-6029
Phone (701) 234-5673

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.99 of 100Reported as group
Quality
92.39
Promoting interoperability
100
Improvement activities
40
Cost
70.9

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 Jul 26, 2012 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 26, 2012 Accepting new patients
Sanford Health Network North CurrentSince Aug 14, 2021 Accepting new patients
Sanford Health Network North Past Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

2801 University Dr S
Fargo, ND 58103
Phone (701) 234-5673

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

407 Washington Ave E
Finley, ND 58230
Phone (701) 524-1005

600 1st St SE
Mayville, ND 58257
Phone (701) 786-4500

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 and National Provider Directory roles.

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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1922353275",
    "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": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-3300",
            "fax_number": "701-364-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71077",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.