NPIMap

Individual provider Active NPI

Michael R Luckenbill, MD

  • Internal Medicine Physician
  • Bismarck, ND
National Provider Identifier
1922108653
Registry record updated Jun 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11592 Issued in ND
Practice address
300 N 7TH St
Bismarck, ND 58501-4439
Phone
(701) 323-8121
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 46495 WI
Internal Medicine Physician 207R00000X 49181 MN
Hospitalist Physician 208M00000X 11592 ND
Internal Medicine Physician 207R00000X 11592 ND Primary

Addresses

Primary practice location

300 N 7TH St
Bismarck, ND 58501-4439

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other identifiers 1

IdentifierTypeStateIssuer
34542100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110322000760 ND Practitioner - HospitalistPractitioner - Internal Medicine 3971579665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of North Dakota School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

300 N 7TH St
Bismarck, ND 58501-4439
Phone (701) 323-6000

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

Hospital & facility affiliations

  • Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015
  • CHI St Alexius Health Dickinson Hospital, Dickinson, ND, CCN 351336
  • Mobridge Regional Hospital - Cah Hospital, Mobridge, SD, CCN 431325
  • Jacobson Memorial Hospital Care Center Hospital, Elgin, ND, CCN 351314
  • South Central Health Hospital, Wishek, ND, CCN 351321

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49181MNMDInternal Medicine Physician
11592NDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck Current Accepting new patients
Sanford Bismarck CurrentSince Jan 12, 2011 Accepting new patients
Sanford Bismarck CurrentSince Jan 12, 2011 Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients

Locations

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

300 N 7th St
Bismarck, ND 58501
Phone (701) 323-6153

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1922108653",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKENBILL",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "46495",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "49181",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ND",
            "license": "11592",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "11592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34542100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.