Individual provider Active NPI

Kyle Wilebski, M.D.

  • Anesthesiology Physician
  • Bismarck, ND
National Provider Identifier
1003298316
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
15712 Issued in ND
Practice address
900 E Broadway Ave
Bismarck, ND 58501-4520
Phone
(701) 530-7000
Fax
(701) 530-8984
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X RL 13722 ND
Student in an Organized Health Care Education/Training Program 390200000X 11018737A IN
Anesthesiology Physician 207L00000X 15712 ND Primary

Addresses

Primary practice location

900 E Broadway Ave
Bismarck, ND 58501-4520

Mailing address

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Other identifiers 1

IdentifierTypeStateIssuer
1477922MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191002001121 ND Practitioner - Anesthesiology 9537454889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of North Dakota School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

  • CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RL 13722NDMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Mar 9, 2022 Accepting new patients
St. Alexius Medical Center CurrentSince Mar 9, 2022 Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1003298316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-7000",
            "fax_number": "701-530-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-7000",
            "fax_number": "701-530-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEBSKI",
        "first_name": "KYLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ND",
            "license": "RL 13722",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11018737A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ND",
            "license": "15712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477922",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.