NPIMap

Individual provider Active NPI

Mary Elizabeth Logue, M.D.

  • Dermatology Physician
  • Minot, ND
National Provider Identifier
1336671445
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
17642 Issued in ND
Practice address
400 Burdick Expy E
Minot, ND 58701-4768
Phone
(701) 857-7382
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X NM
Dermatology Physician 207N00000X 17642 ND Primary

Addresses

Primary practice location

400 Burdick Expy E
Minot, ND 58701-4768

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (018) 577-3827

Other practice location 1

1021 Medical Arts Ave Msc 07-4240
Albuquerque, NM 87131-4619
Phone (505) 272-6000

Other practice location 2

1021 Medical Arts Ave Msc 07-4240
Albuquerque, NM 87131-4619
Phone (505) 272-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240104001929 SD Practitioner - Dermatology 7618249061 Reassigns benefits to 2 organizations
I20260415000275 TX Practitioner - Dermatology 7618249061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, shared by 12 NPIs, 163 clinicians
Great Plains Tribal Chairmen'S Health BoardGroup PAC ID 0648609917, 64 clinicians

Practice addresses (Care Compare)

2140 Junction Ave
Sturgis, SD 57785-2358
Phone (605) 720-2400

3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone 60535525002356

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal of skin lesions333
Removal of skin cancer41
Removal or shaving of skin growth1-10
Skin biopsy94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17642NDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. Current Accepting new patients
Monument Health Network, Inc. CurrentSince Nov 5, 2025 Accepting new patients
Monument Health Network, Inc. CurrentSince Nov 28, 2023 Accepting new patients
Monument Health Network, Inc. CurrentSince Nov 28, 2023 Accepting new patients
Queen City Regional Medical Clinic Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

550 E Colorado Blvd
Spearfish, SD 57783
Phone (605) 642-2030

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

2140 Junction Ave
Sturgis, SD 57785
Phone (605) 720-2400

Interoperability endpoints

  • Direct secure messaging: mlogue.149906@regionalhealth.sdhealthlink.net

Organizations & group practices 6

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 9

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1336671445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "018-577-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BURDICK EXPY E",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014768",
            "telephone_number": "701-857-7382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Medical Arts Ave Msc 07-4240",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871314619",
            "country_code": "US",
            "telephone_number": "505-272-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Medical Arts Ave Msc 07-4240",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871314619",
            "country_code": "US",
            "telephone_number": "505-272-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGUE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ND",
            "license": "17642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.