Active NPI
Madison Jae Hetletved, APRN, CNP
- Family Medicine Physician
- Bismarck, ND
National Provider Identifier
1588522908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 203965
- Practice address
- 727 Kirkwood Mall
Bismarck, ND 58504-5753 - Phone
- (701) 712-4501
- NPI assigned
- Jan 14, 2026
- Last updated
- Apr 20, 2026
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 203965 | ND | Primary |
Addresses
Primary practice location
727 Kirkwood Mall
Bismarck, ND 58504-5753
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
727 Kirkwood Mall
Bismarck, ND 58504-5753
Phone (701) 712-4500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 203965 | ND | MD | Family Medicine Physician |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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": "1768348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776643200000",
"number": "1588522908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 KIRKWOOD MALL",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585045753",
"telephone_number": "701-712-4501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETLETVED",
"first_name": "MADISON",
"middle_name": "JAE",
"credential": "APRN, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-14",
"last_updated": "2026-04-20",
"certification_date": "2026-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ND",
"license": "203965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.