NPIMap

Individual provider Active NPI

Robert Ray Reynolds, M.D.

  • Radiation Oncology Physician
  • Bismarck, ND
National Provider Identifier
1285868968
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
14404 Issued in ND
Practice address
500 N 8TH St
Bismarck, ND 58501
Phone
(701) 222-6100
Fax
(701) 222-6150
NPI assigned
May 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MMD.32576LL SC
Radiation Oncology Physician 2085R0001X 2014034663 MO
Radiation Oncology Physician 2085R0001X 14404 ND Primary
Internal Medicine Physician 207R00000X BP10034767 TX

Addresses

Primary practice location

500 N 8TH St
Bismarck, ND 58501

Mailing address

500 N 8TH St
Bismarck, ND 58501-4445
Phone (701) 222-6100

Other identifiers 1

IdentifierTypeStateIssuer
1469785MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170214002812 ND Practitioner - Radiation Oncology 2264758994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Texas Medical Branch at Galveston, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bismarck Cancer CenterGroup PAC ID 3779542238, 5 clinicians

Practice addresses (Care Compare)

500 N 8TH St
Bismarck, ND 58501-4445
Phone (701) 222-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.44 of 100Reported as group
Quality
98.88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10034767TXMDInternal Medicine Physician
2014034663MOMDRadiation Oncology Physician
14404NDMDRadiation Oncology Physician
MMD.32576LLSCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bismarck Cancer Center Radiation Oncology CurrentSince Feb 8, 2017 Accepting new patients

Locations

500 N 8th St
Bismarck, ND 58501
Phone (701) 222-6100

Interoperability endpoints

  • Direct secure messaging: bonnie.goins@cancercare.direct.varian.com

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1285868968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N 8TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014445",
            "telephone_number": "701-222-6100",
            "fax_number": "701-222-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 8TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-222-6100",
            "fax_number": "701-222-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ROBERT",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-08",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SC",
            "license": "MMD.32576LL",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2014034663",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "ND",
            "license": "14404",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10034767",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469785",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.