Individual provider Active NPI

Michael Ray Brown, MD, PHD

  • Vascular Surgery Physician
  • Bismarck, ND
National Provider Identifier
1912007642
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
8444 Issued in ND
Practice address
310 N 10TH St
Bismarck, ND 58501-4516
Phone
(701) 530-7500
Fax
(701) 530-7484
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 8444 ND
Vascular Surgery Physician 2086S0129X 8444 ND Primary

Addresses

Primary practice location

310 N 10TH St
Bismarck, ND 58501-4516

Mailing address

310 N 10TH St
Bismarck, ND 58501-4516
Phone (701) 530-7500

Other identifiers 2

IdentifierTypeStateIssuer
P00200131OtherNDRAILROAD MEDICARE
1912007642OtherNDNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040624000486 ND Practitioner - Cardiac SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic Surgery 3870579667 Reassigns benefits to 2 organizations
I20160503000007 IL Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 3870579667 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Aug 8, 2018 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Mar 28, 2016 Accepting new patients
Proctor Health Systems Current Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Proctor Health Systems CurrentSince Mar 28, 2016 Accepting new patients
St. Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
St Alexius Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Sanford Bismarck CurrentSince Aug 8, 2018 Accepting new patients
Proctor Health Systems CurrentSince Mar 28, 2016 Accepting new patients
Missouri Basin Anesthesia, PLLC Past Accepting new patients

Locations

1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

815 Main St
Ste A1
Peoria, IL 61602

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

310 N 10th St
Bismarck, ND 58501
Phone (701) 530-7500

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

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Interoperability endpoints

  • Direct secure messaging: mbrown128423@achce.catholichealth.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1912007642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N 10TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014516",
            "telephone_number": "701-530-7500",
            "fax_number": "701-530-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 10TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014516",
            "telephone_number": "701-530-7500",
            "fax_number": "701-530-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ND",
            "license": "8444",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "ND",
            "license": "8444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00200131",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912007642",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.