Joseph Mark Ebertz, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

5421 Issued in ND

Practice address

2700 State St
Bismarck, ND 58503-0669

Phone

(701) 712-4500

Fax

(701) 712-4011

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mid Dakota Clinic, Inc.

  • Clinic/Center
  • Bismarck, ND
  • NPI 1275587826
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1649224809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014507",
            "telephone_number": "701-712-4500",
            "fax_number": "701-712-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 STATE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030669",
            "telephone_number": "701-712-4500",
            "fax_number": "701-712-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERTZ",
        "first_name": "JOSEPH",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ND",
            "license": "5421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "070015671",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11591",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne M Earsley, PA-C
• Sara L Eastman, LMSW
• Megan Noel Ebel, PT, DPT
• Sheila Eberhart
• George Ebertz
• Teresa Eckdahl
• Chandler Eckelberry
• Darnell M Eckert, LSW
• Emily Suzanne Eckroth, MD
• Gordon Eckroth, LICSW/BCD

• Dermatology Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Dermatology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.