Individual provider Active NPI

Marcus M Fiechtner, MD

  • Otolaryngology Physician
  • Bismarck, ND
National Provider Identifier
1205859014
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
3047 Issued in ND
Practice address
715 E Broadway Ave Ste 110
Bismarck, ND 58501-4454
Phone
(701) 323-6000
Fax
(701) 323-6781
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 3047 ND Primary

Addresses

Primary practice location

715 E Broadway Ave Ste 110
Bismarck, ND 58501-4454

Mailing address

PO Box 5501
Bismarck, ND 58506-5501
Phone (701) 323-6000

Other identifiers 1

IdentifierTypeStateIssuer
12308MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3047NDMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck Current Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients
Fort Yates Indian Health Service Hospital Past Accepting new patients
Fort Yates Indian Health Service Hospital Past Accepting new patients

Organizations & group practices 4

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1205859014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5501",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585065501",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E BROADWAY AVE STE 110",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014454",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIECHTNER",
        "first_name": "MARCUS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "3047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12308",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.