Bismarck Dermatology Center PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BISMARCK DERMATOLOGY CENTER PC

Practice address

4207 Boulder Ridge Rd
Bismarck, ND 58503-6163

Phone

(701) 673-3376

NPI assigned

Feb 22, 2021

Organization subpart

No

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

Authorized official

Name

Brenda Bosch

Title

Business Manager

Phone

(701) 220-4858

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00033

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Eugene Cornatzer Jr., M.D.

  • Dermatology Physician
  • Bismarck, ND
  • NPI 1952360711

  Dermatology, ND

  Medicare reassignment NPD
• Morgan Reese, PA-C

  • Physician Assistant
  • Bismarck, ND
  • NPI 1275909244

  ND

  Medicare reassignment

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1265026165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 BOULDER RIDGE RD",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585036163",
            "telephone_number": "701-673-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 BOULDER RIDGE RD",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585036163",
            "telephone_number": "701-673-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISMARCK DERMATOLOGY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "BOSCH",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "701-220-4858"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952360711",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "williamcornatzer@midco.net",
            "affiliation": "N",
            "address_1": "4207 Boulder Ridge Rd",
            "city": "Bismarck",
            "state": "ND",
            "country_code": "US",
            "postal_code": "585036163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "williamcornatzer@midco.net",
            "affiliation": "N",
            "address_1": "4207 Boulder Ridge Rd",
            "city": "Bismarck",
            "state": "ND",
            "country_code": "US",
            "postal_code": "585036163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "williamcornazter@midco.net",
            "affiliation": "N",
            "address_1": "4207 Boulder Ridge Rd",
            "city": "Bismarck",
            "state": "ND",
            "country_code": "US",
            "postal_code": "585036163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melinda Bischoff-Voeller
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• Bismarck Eyecare, P.C.
• Bismarck Family Dental,PC
• Bismarck Hearing PLLC
• Bismarck Lasik
• Bismarck Nephrology Inc.

• All providers in Bismarck, ND
• Dermatology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.