Avera St. Luke'S
NPI 1619273927 · Plastic and Reconstructive Surgery Physician · Fargo, ND
Avera St. Luke'S is a Plastic and Reconstructive Surgery Physician organization in Fargo, ND (NPI 1619273927).
Provider details
- NPI number
- 1619273927
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ron Jacobson, Ceo(605) 622-5125
- License
- 10525 (SD)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Cosmetics and Plastic Surgery
Registry dates
- Enumerated
- 2011-02-03
- Last updated
- 2011-06-30
Frequently asked questions
- What is Avera St. Luke'S's NPI number?
- Avera St. Luke'S's National Provider Identifier (NPI) is 1619273927, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Avera St. Luke'S?
- Avera St. Luke'S is classified in the NPPES registry as Plastic and Reconstructive Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Avera St. Luke'S located?
- Avera St. Luke'S's practice location on file with NPPES is 4141 31st Ave S Ste 105, Fargo, ND 58104-8778.
- What is Avera St. Luke'S's phone number?
- The practice phone number listed in the NPPES registry for Avera St. Luke'S is (605) 725-5030.
- Who is the authorized official for Avera St. Luke'S?
- The authorized official listed on Avera St. Luke'S's NPPES record is Ron Jacobson, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Avera St. Luke'S's NPI active?
- Yes — Avera St. Luke'S's NPI (1619273927) is active in the NPPES registry as of the last update on 2011-06-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.