Active NPI
Puvanalingam Ayyadurai, MD
- Cardiovascular Disease Physician
- Grand Forks, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 15887
- Practice address
- 1300 S Columbia Rd
Grand Forks, ND 58201-4012 - Phone
- (701) 780-2300
- NPI assigned
- Jul 10, 2014
- Last updated
- Jun 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Cardiovascular Disease Physician | 207RC0000X | 15887 | ND | Primary |
Addresses
Primary practice location
1300 S Columbia Rd
Grand Forks, ND 58201-4012
Mailing address
2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-4085
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Altru Health System
Practice addresses (Care Compare)
1300 S Columbia Rd
Grand Forks, ND 58201-4012
Phone (701) 780-5000
400 S Minnesota St
Crookston, MN 56716-1808
Phone (218) 281-9100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current | Accepting new patients |
Locations
400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100
607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357
19120 200th St
Greenbush, MN 56726
Phone (218) 782-2400
711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365
412 Main Ave NE
Warroad, MN 56763
Phone (218) 386-2020
164 W 13th St
Grafton, ND 58237
Phone (701) 352-1620
1300 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-2300
1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000
2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Grand Forks, ND
- NPI 1154346161
-
dba Altru Clinic - East Grand Forks
- Clinic/Center
- East Grand Forks, MN
- NPI 1740621556
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grand Forks, ND
- NPI 1154346161
-
dba Unity Medical Center
- Critical Access Hospital
- Grafton, ND
- NPI 1245216852
-
- Critical Access Hospital
- Cavalier, ND
- NPI 1760542500
-
dba Towner County Medical Center
- Rural Acute Care Hospital
- Cando, ND
- NPI 1154352169
-
- Critical Access Hospital
- Roseau, MN
- NPI 1609861095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591056000000",
"number": "1972919942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 DEMERS AVE",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "58201",
"telephone_number": "701-780-4085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 S COLUMBIA RD",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014012",
"telephone_number": "701-780-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYYADURAI",
"first_name": "PUVANALINGAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-10",
"last_updated": "2020-06-02",
"certification_date": "2020-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "ND",
"license": "15887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.