Organization Active NPI

Bismarck Radiology Associates PC

  • Diagnostic Radiology Physician
  • Bismarck, ND
National Provider Identifier
1750159398
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BISMARCK RADIOLOGY ASSOCIATES PC
Practice address
900 E Broadway Ave
Bismarck, ND 58501-4520
Phone
(701) 333-8354
NPI assigned
Dec 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Authorized official

Name
Luke B Roller, MDNPI 1962769059
Title
MD
Phone
(701) 530-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

900 E Broadway Ave
Bismarck, ND 58501-4520

Mailing address

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 333-8354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240314002127 ND Part B Supplier - Clinic/Group Practice 9739525569 Receives reassigned benefits from 7 practitioners
Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1750159398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-333-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-333-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISMARCK RADIOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "ROLLER",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "701-530-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.