Individual provider Active NPI

Andrew Dockter, MD

  • Family Medicine Physician
  • Mandan, ND
National Provider Identifier
1255851077
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18998 Issued in ND
Practice address
910 18TH St NW
Mandan, ND 58554-1612
Phone
(701) 667-5100
NPI assigned
Jun 22, 2017
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18998 ND Primary

Addresses

Primary practice location

910 18TH St NW
Mandan, ND 58554-1612

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230329001449 ND Practitioner - Family Practice 8921365297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

3318 N 14TH St
Bismarck, ND 58503-1614
Phone (701) 323-8300

910 18TH St NW
Mandan, ND 58554-1612
Phone (701) 667-5100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0399SDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck Single Specialty CurrentSince Jan 2, 2023 Accepting new patients

Locations

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

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

910 18th St NW
Mandan, ND 58554
Phone (701) 323-8400

Organizations & group practices 1

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 2

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1255851077",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 18TH ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585541612",
            "telephone_number": "701-667-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKTER",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "18998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

Verify at the official NPI Registry.