Individual provider Active NPI

Karlee J Kristensen, PA

  • Physician Assistant
  • Bismarck, ND
National Provider Identifier
1417257635
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0917 Issued in ND
Practice address
1040 Tacoma Ave
Bismarck, ND 58504-7452
Phone
(701) 323-6990
Fax
(701) 323-8973
NPI assigned
Oct 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0917 ND Primary

Addresses

Primary practice location

1040 Tacoma Ave
Bismarck, ND 58504-7452

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

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
I20101119000946 ND Practitioner - Physician Assistant 5294921995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

1040 Tacoma Ave
Bismarck, ND 58504-7452
Phone (701) 323-6990

3318 N 14TH St
Bismarck, ND 58503-1614
Phone (701) 323-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAC0917NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Dec 30, 2022 Accepting new patients
Sanford Bismarck Current Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

1040 Tacoma Ave
Bismarck, ND 58504
Phone (701) 323-6990

225 N 7th St
Bismarck, ND 58501
Phone (701) 224-9471

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": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1417257635",
    "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",
            "telephone_number": "605-328-6585",
            "fax_number": "701-323-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 TACOMA AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585047452",
            "telephone_number": "701-323-6990",
            "fax_number": "701-323-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTENSEN",
        "first_name": "KARLEE",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.