Travis Booke, PA-C
Individual provider Active NPI Physician Assistant · Dickinson, ND
NPI 1801316716 · NPPES record last updated Aug 1, 2018
Key facts
- NPI
- 1801316716
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 2500 Fairway St
Dickinson, ND 58601 - Phone
- (701) 456-4000
- NPI assigned
- Jun 21, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Joseph'S Hospital and Health Center
Practice addresses (Care Compare)
2500 Fairway St
Dickinson, ND 58601-2639
Phone (701) 456-4000
95 NW 2ND St
Beach, ND 58621
Phone (701) 872-3777
Hospital & facility affiliations
- CHI St Alexius Health Dickinson
- Sanford Medical Center Bismarck
- CHI St Alexius Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170815000679 | ND | Practitioner - Physician Assistant | 7012289861 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Joseph'S Hospital and Health Center | Current |
Accepting new patients | |
| St Josephs Hospital and Health Center | Current |
Accepting new patients | |
| St Joseph'S Hospital and Health Center | Past | Accepting new patients |
Locations
7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033
2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
2500 Fairway St
Dickinson, ND 58601
Mailing address
2500 Fairway Street
Dickinson, ND 58601-3463
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1471770 | Medicaid | ND |
Other providers in Dickinson, ND
- Stephanie Barbara Bohan
- Anastasiia Boiko
- Salva Bokanga
- Sri Puja Bolligarla
- Tonya Boltz
- Renee L. Boomgaarden
- Preston Borsheim
- Melinda A Borts
- Heather Lee Boxrud
- Kerry D Brady
All providers in Dickinson, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.