Individual provider Active NPI

Collette Rae Lessard, MD

  • Obstetrics & Gynecology Physician
  • Grand Forks, ND
National Provider Identifier
1619107380
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
12836 Issued in ND
Practice address
1380 S Columbia Rd - Altru Family Medicine Center
Grand Forks, ND 58201
Phone
(701) 795-2000
NPI assigned
Jul 16, 2009
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 12836 ND Primary

Addresses

Primary practice location

1380 S Columbia Rd - Altru Family Medicine Center
Grand Forks, ND 58201

Mailing address

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

Other names 1

  • Dr. Collette Rae Lessard Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clessard63216@direct.directaltru.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000396 ND Practitioner - Obstetrics/Gynecology 8022205053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Dakota School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

960 S Columbia Rd
Grand Forks, ND 58201-4030
Phone (701) 780-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12836NDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Obstetrics & Gynecology Current Accepting new patients
Altru Health System CurrentSince Nov 18, 2013 Accepting new patients
Altru Health System CurrentSince Nov 18, 2013 Accepting new patients
Christian Unity Hospital Corporation Past Accepting new patients
Cavalier Optometry Clinic LTD Past Accepting new patients

Locations

201 E 3rd Ave S
Cavalier, ND 58220
Phone (701) 265-8338

301 Mountain St E
Ste A
Cavalier, ND 58220
Phone (701) 265-4196

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

1300 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-2300

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

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

960 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5400

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 2

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": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1619107380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 S COLUMBIA RD - ALTRU FAMILY MEDICINE CENTER",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-795-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSARD",
        "first_name": "COLLETTE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "12836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clessard63216@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "Direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1380 S Columbia Rd - Altru Family Medicine Center",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COLLETTE",
            "last_name": "LESSARD",
            "middle_name": "RAE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.