Avera St. Luke's
NPI 1619273927ActiveOrganization· Surgery, Plastic and Reconstructive Surgery· Fargo, ND
Surgery, Plastic and Reconstructive Surgery in Fargo, North Dakota, registered in NPPES in February 2011. The authorized official on file is Ron L. Jacobson, Ceo.
Overview
| NPI | 1619273927 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 3, 2011 |
| Last updated in NPPES | Jun 30, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Plastic and Reconstructive Surgery Primary | 2086S0122X | 10525 | SD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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