Individual provider Active NPI

Ashley R Serrano, M.A., M.S., PH.D.

  • Clinical Psychologist
  • Bismarck, ND
National Provider Identifier
1093940355
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
651 Issued in ND
Practice address
1800 E Interstate Ave
Bismarck, ND 58503-1399
Phone
(701) 323-8800
NPI assigned
May 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP5792 MN
Clinical Psychologist 103TC0700X 651 ND Primary

Addresses

Primary practice location

1800 E Interstate Ave
Bismarck, ND 58503-1399

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

3333 University Ave SE
Minneapolis, MN 55414-3325
Phone (612) 331-9413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150916001904 MN Practitioner - Clinical Psychologist 0143537670 Reassigns benefits to 2 organizations
I20250327003282 ND Practitioner - Clinical Psychologist 0143537670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

Maple Grove, MN 55369
Phone (701) 323-8800

Rochester, MN 55901
Phone (701) 323-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP5792MNMDClinical Psychologist
651NDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Nov 15, 2023 Accepting new patients
Park Nicollet Clinic CurrentSince Jan 21, 2023 Accepting new patients
Sanford Bismarck CurrentSince Jan 1, 2025 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

1800 E Interstate Ave
Bismarck, ND 58503
Phone (701) 323-6543

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1093940355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E INTERSTATE AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031399",
            "telephone_number": "701-323-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 University Ave SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554143325",
            "country_code": "US",
            "telephone_number": "612-331-9413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "ASHLEY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.A., M.S., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5792",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.