Lee Kiedrowski, MD
Individual provider Active NPI Family Medicine Physician · Bismarck, ND
NPI 1962997338 · NPPES record last updated Jun 27, 2018
Key facts
- NPI
- 1962997338
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- RL15208 (ND)
- Practice address
- 701 E Rosser Ave
Bismarck, ND 58501-4461 - Phone
- (701) 751-9500
- Fax
- (701) 751-9508
- NPI assigned
- Jun 27, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 6
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Dakota School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- McKenzie County Healthcare Systems Inc
Practice addresses (Care Compare)
509 16TH St NE
Suite 3
Watford City, ND 58854-7628
Phone (701) 444-7814
709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000
Hospital & facility affiliations
- CHI Health at Home - HHA
- CHI Health at Home - Hospice
- McKenzie County Healthcare Systems Inc
- Jacobson Memorial Hospital Care Center
- Richardton Health Center Inc
- Marian Manor Healthcare Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Marian Manor Health Care Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Feb 1, 2026 Feb 1, 2026 |
| Richardton Health Center, Inc. |
Skilled nursing facility | Contracted Managing Employee Operational/Managerial Control Adp of the SNF |
Aug 1, 2024 Dec 3, 2024 Dec 10, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201223001300 | ND | Practitioner - Family Practice | 5890107429 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RL15208 | ND | MD | Family Medicine Physician |
Practice roles
Locations
7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033
3290 Solutions Ctr
Chicago, IL 60677
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131
2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000
1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010
525 N Main St
Watford City, ND 58854
Phone (701) 842-3771
709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331
1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | RL15208 | ND | Yes |
Addresses
Primary practice location
701 E Rosser Ave
Bismarck, ND 58501-4461
Mailing address
701 E Rosser Ave
Bismarck, ND 58501-4461
Phone (701) 751-9500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12083 | Medicaid | ND |
NPI Registry JSON
{
"created_epoch": "1530057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530057600000",
"number": "1962997338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 E ROSSER AVE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585014461",
"telephone_number": "701-751-9500",
"fax_number": "701-751-9508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E ROSSER AVE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585014461",
"telephone_number": "701-751-9500",
"fax_number": "701-751-9508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIEDROWSKI",
"first_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-27",
"last_updated": "2018-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ND",
"license": "RL15208",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12083",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
- Amanda Keyser
- Anjala Khadka
- Saifullah Khan
- Rodhan Khthir
- Amir Kichloo
- Jennifer W Kienzle
- Michael N Kienzle
- Kayleen Kihle
- Shelley A Killen
- Leta Pauline Killer
All providers in Bismarck, ND · Family Medicine Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.