Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. EWAENOSA ESOHE ISIDAHOME MD
NPI 1063089514
Pediatrics in Grand Forks, ND

Q: What is Ewaenosa Isidahome's NPI number?

The NPI number for Ewaenosa Isidahome is 1063089514. It was assigned to this individual provider in the NPPES registry on June 4, 2021.

Q: What is Ewaenosa Isidahome's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since June 04, 2021PECOS Enrolled

1200 S COLUMBIA RD, GRAND FORKS, ND 58201(701) 780-5000 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 29, 2026, Nov 22, 2024, Jun 4, 2021 (3 updates tracked since 2021).

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About Dr. Ewaenosa Esohe Isidahome Md NPPES

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

DR. EWAENOSA ESOHE ISIDAHOME MD (NPI 1063089514) is an individual pediatrics provider in Grand Forks, North Dakota, licensed in North Dakota (PT24940) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063089514

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. EWAENOSA ESOHE ISIDAHOMECredential: MD

Location Address1200 S COLUMBIA RDGrand Forks, ND 58201-4036

Mailing AddressPo Box 860939Minneapolis, MN 55486-0939

Phone(701) 780-5000

Sole ProprietorNo

Enumeration DateJune 4, 2021

Last NPPES UpdateSeptember 29, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2026

✔ NPI 1063089514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in ND · PT24940

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1200 S COLUMBIA RD, Grand Forks, ND 58201

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ewaenosa Esohe Isidahome Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Ewaenosa Isidahome reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Montefiore Medical Center

1,239 mi

Family Medicine

2633 BROADWAY
New York, NY 10025

Reassigned Medicare billing, New York enrollment
5,251 clinicians in this Medicare group

NPI 1760288278 (888) 663-6331

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Other Providers at the Same Location NPPES 20

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

RAYMOND CHERIAN

Internal Medicine