Active NPI
Amanda Skluzacek, PT
- Physical Therapist
- Dickinson, ND
National Provider Identifier
1376783134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1523
- Practice address
- 2615 Fairway St
Dickinson, ND 58601-2590 - Phone
- (701) 456-6000
- NPI assigned
- Mar 5, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1523 | ND | Primary |
Addresses
Primary practice location
2615 Fairway St
Dickinson, ND 58601-2590
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other practice location 1
1500 14th St W
Ste 350
Williston, ND 58801-4076
Phone (701) 572-1848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130227000527 | ND | Practitioner - Physical Therapist in Private Practice | 6608021472 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Bismarck
Practice addresses (Care Compare)
2615 Fairway St
Dickinson, ND 58601-2590
Phone (701) 456-6000
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.63 of 100
- Quality
- 89.39
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.04
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1523 | ND | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Bismarck | Current | Accepting new patients |
Locations
3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300
2615 Fairway St
Dickinson, ND 58601
Phone (701) 456-6000
Organizations & group practices 10
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.
-
- Clinical Medical Laboratory
- Bismarck, ND
- NPI 1154485944
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Fort Yates, ND
- NPI 1396828547
-
- Community Based Hospice Care Agency
- Mandan, ND
- NPI 1477631745
-
- General Acute Care Hospital
- Bismarck, ND
- NPI 1538245634
-
- Ambulatory Surgical Clinic/Center
- Dickinson, ND
- NPI 1598185597
-
- Home Health Agency
- Mandan, ND
- NPI 1669555744
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Bismarck, ND
- NPI 1700962818
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Jamestown, ND
- NPI 1720161953
-
- Community/Retail Pharmacy
- Bismarck, ND
- NPI 1790889715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1376783134",
"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": "2615 FAIRWAY ST",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586012590",
"telephone_number": "701-456-6000"
}
],
"practiceLocations": [
{
"address_1": "1500 14th St W",
"address_2": "Ste 350",
"address_purpose": "LOCATION",
"city": "Williston",
"state": "ND",
"postal_code": "588014076",
"country_code": "US",
"telephone_number": "701-572-1848",
"fax_number": "701-572-2476",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SKLUZACEK",
"first_name": "AMANDA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-05",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "1523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dickinson, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.