Active NPI
Burton S Belknap, MD
- Dermatology Physician
- Fargo, ND
National Provider Identifier
1770516478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 4372
- Practice address
- 1702 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 364-3300
- Fax
- (701) 364-8906
- NPI assigned
- Jul 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 4372 | ND | Primary |
Addresses
Primary practice location
1702 University Dr S
Fargo, ND 58103-4940
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-3300
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0300189 | Other | ND | MEDICA # |
| FS9011015508 | Other | ND | PREFERRED ONE # |
| 0300103 | Other | ND | MEDICA # |
| 75 | Other | ND | NDBS # |
| 829897100 | Medicaid | ND | |
| 900329 | Other | ND | AMERICA'S PPO/ARAZ # |
| HP25705 | Other | ND | HEALTHPARTNERS # |
| 23469 | Other | ND | SIOUX VALLEY # |
| ND200002 | Other | ND | LHS # |
| 141995 | Other | ND | UCARE# |
| 13272 | Medicaid | ND |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071211000066 | ND | Practitioner - Dermatology | 1759470966 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4372 | ND | MD | Dermatology Physician |
| 23376 | MN | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1770516478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELKNAP",
"first_name": "BURTON",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "ND",
"license": "4372",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "0300189",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE #",
"identifier": "FS9011015508",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "0300103",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "75",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "829897100",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO/ARAZ #",
"identifier": "900329",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP25705",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIOUX VALLEY #",
"identifier": "23469",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LHS #",
"identifier": "ND200002",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE#",
"identifier": "141995",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "13272",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.