Individual provider Active NPI

Ryan A. Hoovestol, M.D.

  • Internal Medicine Physician
  • Fargo, ND
National Provider Identifier
1972769677
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11954 Issued in ND
Practice address
2101 Elm St N
Fargo, ND 58102-2498
Phone
(701) 221-9152
Fax
(701) 221-0918
NPI assigned
Aug 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11954 ND Primary

Addresses

Primary practice location

2101 Elm St N
Fargo, ND 58102-2498

Mailing address

2101 Elm St N
Fargo, ND 58102-2417
Phone (701) 221-9152

Other identifiers 1

IdentifierTypeStateIssuer
1452578MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110907001231 ND Practitioner - Internal Medicine 2961672621 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Jul 11, 2011 Accepting new patients
St. Alexius Medical Center CurrentSince Jul 11, 2011 Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1972769677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022417",
            "telephone_number": "701-221-9152",
            "fax_number": "701-221-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022498",
            "telephone_number": "701-221-9152",
            "fax_number": "701-221-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVESTOL",
        "first_name": "RYAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "11954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452578",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.