Individual provider Active NPI

Richelle Melanie Knudson, M.D.

  • Dermatology Physician
  • Bismarck, ND
National Provider Identifier
1811149156
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
12939 Issued in ND
Practice address
2830 N Washington St
Bismarck, ND 58503-1482
Phone
(701) 323-6400
Fax
(701) 323-5677
NPI assigned
Oct 17, 2008
Last updated
Sep 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RL10955 ND
Dermatology Physician 207N00000X 104460 MN
Dermatology Physician 207N00000X 52270 MN
Dermatology Physician 207N00000X 12939 ND Primary

Addresses

Primary practice location

2830 N Washington St
Bismarck, ND 58503-1482

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other identifiers 4

IdentifierTypeStateIssuer
18404MedicaidND
ENROLLEDMedicaidIA
ENROLLEDMedicaidMN
P00839007OtherMNRAILROAD MEDICARE

Other names 1

  • Richelle Melanie Blanchard Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131126001031 ND Practitioner - Dermatology 3375689805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of North Dakota School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

2830 N Washington St
Bismarck, ND 58503-1482
Phone (701) 323-6400

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision171
Removal of skin lesions99
Removal of skin cancer805
Removal or shaving of skin growth1-10
Skin biopsy63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RL10955NDMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Oct 12, 2015 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 12, 2015 Accepting new patients
Sanford Bismarck CurrentSince Aug 31, 2013 Accepting new patients
Sanford Bismarck CurrentSince Aug 31, 2013 Accepting new patients
Medcenter One Inc Past Accepting new patients

Locations

2603 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5222

2830 N Washington St
Bismarck, ND 58503
Phone (701) 323-5400

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

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 5

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 1

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": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1811149156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 N WASHINGTON ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031482",
            "telephone_number": "701-323-6400",
            "fax_number": "701-323-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "RICHELLE",
        "middle_name": "MELANIE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ND",
            "license": "RL10955",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "104460",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "52270",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ND",
            "license": "12939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18404",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00839007",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHELLE",
            "last_name": "BLANCHARD",
            "middle_name": "MELANIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.