Individual provider Active NPI

David Gordon Affleck, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Bismarck, ND
National Provider Identifier
1710979653
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
24469 Issued in ND
Practice address
222 N 7TH St
Bismarck, ND 58501-4436
Phone
(701) 323-6000
Fax
(701) 323-6249
NPI assigned
Aug 17, 2005
Last updated
May 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 346120-1206 UT
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 24469 ND Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 3461201205 UT

Addresses

Primary practice location

222 N 7TH St
Bismarck, ND 58501-4436

Mailing address

PO Box 281490
Atlanta, GA 30384-1490

Other practice location 1

1160 E 3900 S
Suite 3500
Salt Lake City, UT 84124-1202
Phone (801) 743-4750

Other practice location 2

300 N 7th St
Bismarck, ND 58501-4439
Phone (701) 323-6000

Other identifiers 4

IdentifierTypeStateIssuer
134332141OtherUTTAX IDENTIFICATION
D5506MedicaidUT
P00424176OtherUTRR MEDICARE
PENDINGMedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daffleck2991@epicmtn.hcadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ND2 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
I20040517000685 UT Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 2961492392 Reassigns benefits to 1 organization
I20260613000114 ND Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 2961492392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
University of Utah School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainstar Cardiovascular Services LLCGroup PAC ID 1951404110, 14 clinicians
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

1160 E 3900
Suite 3500
Salt Lake City, UT 84124-1264
Phone (801) 743-4750

1200 E 3900
Salt Lake City, UT 84124-1300
Phone (801) 268-7111

300 N 7TH St
Bismarck, ND 58501-4439
Phone (701) 323-6000

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)11
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
346120-1206UTMDVascular Surgery Physician
24469NDMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
3461201205UTMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainstar Cardiovascular Services LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jan 2, 2007 Accepting new patients
Mountainstar Cardiology St Marks LLC Past Accepting new patients

Locations

5405 S 500 E
Ste 200
Ogden, UT 84405
Phone (801) 476-6900

750 W 800 N
Orem, UT 84057
Phone (801) 714-6000

1160 E 3900 S
Ste 3500
Salt Lake Cty, UT 84124
Phone (801) 476-6900

1160 E 3900 S
Ste 2000
Slc, UT 84124
Phone (801) 266-3418

Organizations & group practices 3

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1710979653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281490",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841490"
        },
        {
            "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",
            "fax_number": "701-323-6249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1160 E 3900 S",
            "address_2": "SUITE 3500",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841241202",
            "country_code": "US",
            "telephone_number": "801-743-4750",
            "fax_number": "801-743-4765",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585014439",
            "country_code": "US",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AFFLECK",
        "first_name": "DAVID",
        "middle_name": "GORDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "UT",
            "license": "346120-1206",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ND",
            "license": "24469",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "UT",
            "license": "3461201205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "134332141",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D5506",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00424176",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daffleck2991@epicmtn.hcadirect.net",
            "affiliation": "N",
            "address_1": "1160 E 3900 S",
            "address_2": "SUITE 3500",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841241202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.