NPIMap

Individual provider Active NPI

Mark S Kristy, MD

  • Diagnostic Radiology Physician
  • Hettinger, ND
National Provider Identifier
1609974195
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
7219 Issued in ND
Practice address
1000 Highway 12
Hettinger, ND 58639-7530
Phone
(701) 567-4561
Fax
(701) 567-6363
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 7219 ND Primary

Addresses

Primary practice location

1000 Highway 12
Hettinger, ND 58639-7530

Mailing address

1000 Highway 12
Hettinger, ND 58639-7530
Phone (701) 567-4561

Other identifiers 7

IdentifierTypeStateIssuer
13032OtherNDBC/BS
658162-00MedicaidMN
7781732MedicaidSD
4503468812MedicaidNE
A13801044310OtherPREFERREDONE
18409MedicaidND
1914556MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000458 ND Practitioner - Diagnostic Radiology 1850291436 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West River Health ServicesGroup PAC ID 0042127045, shared by 8 NPIs, 18 clinicians
St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

1000 Hwy 12
Hettinger, ND 58639-7530
Phone (701) 567-4561

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Sep 22, 2025 Accepting new patients
West River Health Services CurrentSince Apr 21, 1995 Accepting new patients
St. Alexius Medical Center CurrentSince Sep 22, 2025 Accepting new patients
West River Health Services CurrentSince Apr 21, 1995 Accepting new patients
West River Health Services CurrentSince Apr 21, 1995 Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

1000 Highway 12
Hettinger, ND 58639
Phone (701) 567-4561

Interoperability endpoints

  • Direct secure messaging: markkristy@wrhs.allscriptsdirect.net

Organizations & group practices 5

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 6

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609974195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 12",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586397530",
            "telephone_number": "701-567-4561",
            "fax_number": "701-567-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 12",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586397530",
            "telephone_number": "701-567-4561",
            "fax_number": "701-567-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTY",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "7219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "13032",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "658162-00",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7781732",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4503468812",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "A13801044310",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18409",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1914556",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hettinger, ND

Sources for this page

Verify at the official NPI Registry.