Kyle Cleasby
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fargo, ND
NPI 1093375370 · NPPES record last updated Jan 23, 2023
Key facts
- NPI
- 1093375370
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1919 Elm St N
Fargo, ND 58102-2416 - Phone
- (701) 293-4113
- Fax
- (701) 293-4109
- NPI assigned
- Jun 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Badlands Human Service Center
Practice addresses (Care Compare)
1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone (701) 227-7500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230510001235 | ND | Practitioner - Psychiatry | 3173989522 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18990 | ND | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Central Behavioral Health Clinic | Current |
Accepting new patients | |
| Southeast Behavioral Health Clinic | Current |
Accepting new patients | |
| Lake Region Behavioral Health Clinic | Current |
Accepting new patients | |
| Northeast Human Service Center | Current |
Accepting new patients | |
| South Central Behavioral Health Clinic | Current |
Accepting new patients | |
| Badlands Behavioral Health Clinic | Current |
Accepting new patients | |
| Northeast Behavioral Health Clinic | Current |
Accepting new patients | |
| North Central Behavioral Health Clinic | Current |
Accepting new patients | |
| Northwest Behavioral Health Clinic | Current |
Accepting new patients | |
| Badlands Behavioral Health Clinic | Past |
Accepting new patients |
Locations
600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644
1237 W Divide Ave
Ste 5
Bismarck, ND 58501
Phone (701) 328-8888
200 Highway 2 W
Devils Lake, ND 58301
Phone (701) 665-2200
1463 I94 Business Loop E
Dickinson, ND 58601
Phone (701) 227-7500
300 13th Ave W
Ste 1
Dickinson, ND 58601
Phone (701) 227-7500
2624 9th Ave SW
Fargo, ND 58103
Phone (701) 298-4500
151 S 4th St
Ste 401
Grand Forks, ND 58201
Phone (701) 795-3000
520 3rd St NW
Jamestown, ND 58401
Phone (701) 253-6300
1015 S Broadway
Ste 18
Minot, ND 58701
Phone (701) 857-8500
316 2nd Ave W
Williston, ND 58801
Phone (701) 774-4600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 18990 | ND | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1919 Elm St N
Fargo, ND 58102-2416
Mailing address
1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone (701) 227-7500
Other practice location 1
1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone (701) 227-7500
Other providers in Fargo, ND
- Kim Clausen
- Elijah Clay
- Rachel Ellen Clay
- Emily Clayton
- Clear Path Counseling
- Steven Glenn Clemenson
- Morgan M Clements
- Chris L Cleveland
- Ashton Lorraine Clevenger
- Kristi Clifton
All providers in Fargo, ND · Student in an Organized Health Care Education/Training Program in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.