Individual provider Active NPI

Robert Allen Pathroff, MD

  • Urology Physician
  • Bismarck, ND
National Provider Identifier
1912947847
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
5534 Issued in ND
Practice address
225 North 7TH Street
Bismarck, ND 58501
Phone
(701) 224-9471
Fax
(701) 223-8728
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME61633 FL
Urology Physician 208800000X 5534 ND Primary

Addresses

Primary practice location

225 North 7TH Street
Bismarck, ND 58501

Mailing address

225 North 7TH Street
Bismarck, ND 58501
Phone (701) 224-9471

Other identifiers 1

IdentifierTypeStateIssuer
016454MedicaidND

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
I20040406000178 ND Practitioner - Urology 3173415320 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5534NDMDSocial Worker
ME61633FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Apr 1, 2009 Accepting new patients
St. Alexius Medical Center CurrentSince Apr 1, 2009 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

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

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1912947847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NORTH 7TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-224-9471",
            "fax_number": "701-223-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NORTH 7TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-224-9471",
            "fax_number": "701-223-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHROFF",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME61633",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ND",
            "license": "5534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016454",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.