Individual provider Active NPI

Mark Wade Rodacker, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Bismarck, ND
National Provider Identifier
1437261724
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
9611 Issued in ND
Practice address
222 N 7TH St
Bismarck, ND 58501-4436
Phone
(701) 323-6000
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 9611 ND Primary

Addresses

Primary practice location

222 N 7TH St
Bismarck, ND 58501-4436

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

1200 S Columbia Rd - Altru Hospital
Grand Forks, ND 58201
Phone (701) 780-1561

Other identifiers 1

IdentifierTypeStateIssuer
12927MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040415000644 ND Practitioner - Pathology 6709871239 Reassigns benefits to 1 organization
I20180614001377 MN Practitioner - Pathology 6709871239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of North Dakota School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

1500 21St Ave NW
Suite 102
Minot, ND 58703-0867
Phone (701) 418-4300

1700 11TH St W
Williston, ND 58801-4500
Phone (701) 774-7687

2615 Fairway St
Dickinson, ND 58601-2590
Phone (701) 456-6000

33 9TH St W
Dickinson, ND 58601-3950
Phone (701) 483-6017

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

801 21St Ave SE
Minot, ND 58701-6064
Phone (701) 838-3150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Jul 7, 2020 Accepting new patients
Altru Health System CurrentSince Apr 24, 2018 Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357

222 N 7th St
Bismarck, ND 58501
Phone (701) 323-5422

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

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

Organizations & group practices 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1437261724",
    "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": "222 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014436",
            "telephone_number": "701-323-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Columbia Rd - Altru Hospital",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "58201",
            "country_code": "US",
            "telephone_number": "701-780-1561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODACKER",
        "first_name": "MARK",
        "middle_name": "WADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "ND",
            "license": "9611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12927",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.