NPIMap

Organization Active NPI

Dakota Surgery & Laser Center LLC

  • Ambulatory Surgical Clinic/Center
  • Bismarck, ND
National Provider Identifier
1952348013
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
DAKOTA SURGERY & LASER CENTER LLC
Practice address
430 E Sweet Ave
Bismarck, ND 58504-5658
Phone
(701) 222-4900
Fax
(701) 222-4999
NPI assigned
May 31, 2006
Last updated
Apr 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Mrs. Aleesa A Brorby
Title
Administrator
Phone
(701) 222-3937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

430 E Sweet Ave
Bismarck, ND 58504-5658

Mailing address

200 S 5TH St
Bismarck, ND 58504-5675
Phone (701) 222-3937

Other identifiers 1

IdentifierTypeStateIssuer
1452423MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040216000442 ND Part B Supplier - Clinic/Group Practice 0143115683 Receives reassigned benefits from 5 practitioners
Practice locations: Bismarck, ND
O20100415000422 ND Part B Supplier - Ambulatory Surgical Center 0143115683 Practice locations: Bismarck, ND

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Dakota Surgery and Laser Center LLCCCN 35C0001013
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D0939590Dakota Surgery and Laser Center430 E Sweet Ave, Bismarck, ND 58504Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory

Locations

430 E Sweet Ave
Bismarck, ND 58504
Phone (701) 222-4900

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1952348013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 5TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045675",
            "telephone_number": "701-222-3937",
            "fax_number": "701-222-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E SWEET AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045658",
            "telephone_number": "701-222-4900",
            "fax_number": "701-222-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA SURGERY & LASER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "BRORBY",
        "authorized_official_first_name": "ALEESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-222-3937",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452423",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.