NPIMap

Individual provider Active NPI

Wesley Ellison

  • Anatomic Pathology Physician
  • Bismarck, ND
National Provider Identifier
1740391044
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
8189 Issued in ND
Practice address
3502 Franklin Ave
Bismarck, ND 58503-0761
Phone
(701) 222-2480
Fax
(701) 222-4537
NPI assigned
Aug 31, 2006
Last updated
Dec 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 8189 ND Primary

Addresses

Primary practice location

3502 Franklin Ave
Bismarck, ND 58503-0761

Mailing address

PO Box 2036
Bismarck, ND 58502-2036

Other identifiers 3

IdentifierTypeStateIssuer
11227MedicaidND
17894OtherNDBLUE SHIELD
CO4118OtherNDRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101110001264 ND Practitioner - Pathology 7416978333 Reassigns benefits to 2 organizations
I20160518001814 TX Practitioner - Pathology 7416978333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Utah School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Consultants PCGroup PAC ID 2466411525, 5 clinicians

Practice addresses (Care Compare)

3502 Franklin Ave
Bismarck, ND 58503-0761
Phone (701) 222-2480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.34 of 100Reported as group
Quality
96.67
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Pathology Consultants, PC CurrentSince Jul 1, 1999 Accepting new patients
Pathology Consultants, PC CurrentSince Jul 1, 1999 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 9, 2016 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Aug 1, 2017 Accepting new patients
St Joseph's Hospital and Health Center Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 9, 2016 Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility PastSince Jan 23, 2017 Accepting new patients

Locations

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

3502 Franklin Ave
Bismarck, ND 58503
Phone (701) 222-2480

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

Organizations & group practices 8

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1740391044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2036",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585022036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 FRANKLIN AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030761",
            "telephone_number": "701-222-2480",
            "fax_number": "701-222-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "WESLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "ND",
            "license": "8189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11227",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "17894",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CO4118",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.