ETHAN LEE THOMAS FNP-C
NPI 1063017432
Nurse Practitioner - Family in Grand Forks, ND

Q: What is Ethan Thomas's NPI number?

The NPI number for Ethan Thomas is 1063017432. It was assigned to this individual provider in the NPPES registry on December 2, 2020.

Q: What is Ethan Thomas's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Thomas was last updated on October 5, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 02, 2020PECOS EnrolledAccepts Medicare Assignment

4440 S. WASHINGTON ST., GRAND FORKS, ND 58201(701) 732-7000 Get Directions Write a Review

NPPES record last updated: October 5, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 5, 2021, Dec 2, 2020 (2 updates tracked since 2020).

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About Ethan Lee Thomas Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN LEE THOMAS FNP-C (NPI 1063017432) is an individual family provider in Grand Forks, North Dakota, licensed in North Dakota (R40656) and active in the NPI registry since December 2020. He is enrolled in Medicare PECOS, is affiliated with Altru Hospital, and is a graduate of University Of North Dakota School Of Medicine (2020).

NPPES Registry Identity

NPI1063017432

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameETHAN LEE THOMASCredential: FNP-C

Location Address4440 S. WASHINGTON ST.Grand Forks, ND 58201

Mailing Address2401 Demers AveGrand Forks, ND 58201 · (701) 780-6468

Phone(701) 732-7000

Sole ProprietorNo

Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 2020

Enumeration DateDecember 2, 2020

Last NPPES UpdateOctober 5, 20212 updates tracked since enumeration

NPPES CertifiedOctober 5, 2021

✔ NPI 1063017432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in ND · R40656

4440 S. WASHINGTON ST., Grand Forks, ND 58201

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Lee Thomas Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082011291

PECOS Enrollment IDI20210929003795

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

405 services367 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

46 services45 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

20 services20 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

20 services20 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Altru Hospital

Acute Care Hospitals · Grand Forks, ND

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number350019

Location1200 S Columbia RdGrand Forks, ND 58201 · Grand Forks County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $55.75 – $168.12

Typical copayment $21.42 (range $13.93 – $42.03)

Most-billed visit code 99203

Established Patient

$98.29 typical visit price

range $18.11 – $137.65

Typical copayment $24.57 (range $4.52 – $34.41)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

QIANLIN LI DPM

Podiatrist