Individual provider Active NPI

Kevin P Chaussee, FNP

  • Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1962424440
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R25099 Issued in ND
Practice address
1421 Mapleton Ave
Bismarck, ND 58503-5371
Phone
(701) 877-1577
Fax
(833) 592-2359
NPI assigned
Jul 24, 2006
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R25099 ND Primary
Family Nurse Practitioner 363LF0000X R25099 ND

Addresses

Primary practice location

1421 Mapleton Ave
Bismarck, ND 58503-5371

Mailing address

1421 Mapleton Ave
Bismarck, ND 58503-5371
Phone (701) 877-1577

Other identifiers 2

IdentifierTypeStateIssuer
1461171MedicaidND
7771490MedicaidSD

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110907001590 ND Practitioner - Nurse Practitioner 9537339221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradley Gynecology PCGroup PAC ID 2163961855, 8 clinicians

Practice addresses (Care Compare)

3100 N 11TH St
Suite 1
Bismarck, ND 58503-1210
Phone (701) 751-2272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.05 of 100Reported as group
Quality
66.9
Promoting interoperability
95
Improvement activities
40
Cost
80.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R25099NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Dakota Clinic, Inc. CurrentSince Jul 1, 2011 Accepting new patients
St. Alexius Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Bradley Gynecology, P.C. Family CurrentSince Oct 1, 2024 Accepting new patients

Locations

1421 Mapleton Ave
Bismarck, ND 58503
Phone (701) 250-2182

3100 N 11th St
Ste 1
Bismarck, ND 58503
Phone (701) 712-0066

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

Interoperability endpoints

  • Direct secure messaging: kevin.chaussee.1@13694.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1962424440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 MAPLETON AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035371",
            "telephone_number": "701-877-1577",
            "fax_number": "833-592-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 MAPLETON AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035371",
            "telephone_number": "701-877-1577",
            "fax_number": "833-592-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUSSEE",
        "first_name": "KEVIN",
        "middle_name": "P",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R25099",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R25099",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1461171",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7771490",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.