Individual provider Active NPI

Andrea A. Kilzer, FNP

  • Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1265664726
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R30598 Issued in ND
Practice address
900 E Broadway Ave
Bismarck, ND 58501-4520
Phone
(701) 530-7000
NPI assigned
Aug 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R30598 ND Primary

Addresses

Primary practice location

900 E Broadway Ave
Bismarck, ND 58501-4520

Mailing address

PO Box 997
Bismarck, ND 58502-0997
Phone (701) 530-7000

Other identifiers 1

IdentifierTypeStateIssuer
1450764MedicaidND

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091219000139 ND Practitioner - Nurse Practitioner 5799825998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
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)

4315 Ottawa St
Bismarck, ND 58503-6175
Phone (701) 530-3500

807 E Main Ave
Suite a
Bismarck, ND 58501-4527
Phone (701) 530-3700

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

  • CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002

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
R30598NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Alexius Medical Center CurrentSince Aug 24, 2009 Accepting new patients
St Alexius Medical Center CurrentSince Aug 24, 2009 Accepting new patients
Community Memorial Hospital Past Accepting new patients

Locations

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

4315 Ottawa St
Bismarck, ND 58503
Phone (402) 717-1255

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1265664726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 997",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585020997",
            "telephone_number": "701-530-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILZER",
        "first_name": "ANDREA",
        "middle_name": "A.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R30598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1450764",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.