NPIMap

Individual provider Active NPI

Johanes I. Prawira, MD

  • Hospitalist Physician
  • Bismarck, ND
National Provider Identifier
1932337706
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
12013 Issued in ND
Practice address
300 N 7TH St
Bismarck, ND 58501-4439
Phone
(701) 323-6000
Fax
(701) 323-6719
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 61703 MN
Family Medicine Physician 207Q00000X 12013 ND
Hospitalist Physician 208M00000X 12013 ND Primary

Addresses

Primary practice location

300 N 7TH St
Bismarck, ND 58501-4439

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (953) 993-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jprawira8786390@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110809000913 ND Practitioner - HospitalistPractitioner - Family Practice 9830368786 Reassigns benefits to 1 organization
I20170216001155 MN Practitioner - Family Practice 9830368786 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

300 N 7TH St
Bismarck, ND 58501-4439
Phone (701) 323-6000

3318 N 14TH St
Bismarck, ND 58503-1614
Phone (701) 323-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Sep 16, 2018 Accepting new patients
Sanford Bismarck Family Medicine CurrentSince Nov 21, 2016 Accepting new patients
Sanford Bismarck CurrentSince Nov 21, 2016 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Mar 26, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 14, 2017 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 14, 2017 Accepting new patients
Fairview Clinics CurrentSince Feb 14, 2017 Accepting new patients
Fairview Clinics CurrentSince Feb 14, 2017 Accepting new patients
Fairview Health Services CurrentSince Mar 26, 2017 Accepting new patients
Fairview Express Care CurrentSince Sep 16, 2018 Accepting new patients
Sanford Bismarck Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

300 N 7th St
Bismarck, ND 58501
Phone (701) 323-6153

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

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 10

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1932337706",
    "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",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-6719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Excelsior Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554264702",
            "country_code": "US",
            "telephone_number": "953-993-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRAWIRA",
        "first_name": "JOHANES",
        "middle_name": "I.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "61703",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "12013",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ND",
            "license": "12013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jprawira8786390@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "300 N 7th St",
            "city": "Bismarck",
            "state": "ND",
            "country_code": "US",
            "postal_code": "585014439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.