NPIMap

Individual provider Active NPI

Shawna L Dobrzelecki, NP

  • Family Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1205023926
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R33229 Issued in ND
Practice address
811 E Interstate Ave
Bismarck, ND 58503-1100
Phone
(701) 221-0900
NPI assigned
Sep 26, 2007
Last updated
Mar 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 298435 OH
Family Nurse Practitioner 363LF0000X R33229 ND Primary

Addresses

Primary practice location

811 E Interstate Ave
Bismarck, ND 58503-1100

Mailing address

1879 S Grandview LN
Bismarck, ND 58503-0848
Phone (937) 269-1798

Other identifiers 1

IdentifierTypeStateIssuer
000000032022OtherOHBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090904000513 ND Practitioner - Nurse Practitioner 1355430430 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
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

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R33229NDMDFamily Nurse Practitioner
298435OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Devils Lake CurrentSince Apr 1, 2022 Accepting new patients
Carrington Health Center CurrentSince Apr 1, 2022 Accepting new patients
Carrington Health Center CurrentSince Apr 1, 2022 Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
Carrington Health Center Past Accepting new patients

Locations

3290 Solutions Ctr
Chicago, IL 60677

7776 Solutions Ctr
Chicago, IL 60677

820 5th St N
Carrington, ND 58421
Phone (701) 399-0123

1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131

425 College Dr S
Ste 14
Devils Lake, ND 58301
Phone (701) 662-8662

Interoperability endpoints

  • Direct secure messaging: sdobrzelecki266643@achce.catholichealth.net

Organizations & group practices 12

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

Hospital & facility affiliations 3

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1205023926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 S GRANDVIEW LN",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030848",
            "telephone_number": "937-269-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E INTERSTATE AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031100",
            "telephone_number": "701-221-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRZELECKI",
        "first_name": "SHAWNA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "298435",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R33229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000032022",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.