Kyle Matthew Rockers, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

15835 Issued in ND

Practice address

3165 Demers Ave - Truyu Aesthetic Center
Grand Forks, ND 58201-4049

Phone

(701) 780-6623

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

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 2

Specialty

Dermatology

Education

Washington University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krockers95767@direct.directaltru.org

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.

• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  Medicare reassignment Care Compare group NPD
• Altru Health System

  • Clinic/Center
  • Crookston, MN
  • NPI 1760494330
  Medicare reassignment NPD
• Altru Health System

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  NPD

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

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1225028699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 DEMERS AVE - TRUYU AESTHETIC CENTER",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014049",
            "telephone_number": "701-780-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKERS",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "04-37503",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ND",
            "license": "15835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719342",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201101740A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krockers95767@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3165 Demers Ave - Truyu Aesthetic Center",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "582014049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leanne M Robinson, LSW
• Sarah Ann Robinson, MS, CCC-SLP
• Andrew Patrick Roche III, MD
• Conor Scott Roche, M.D
• Ian Roche, MD
• Brianna Rocksvold
• Leslie Erica Rodriguez, NP-C
• James R Roed, MD
• Rhonda Mae Roed, OTRL
• Colleen Roeder, FNP

• Dermatology Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Dermatology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.