NPIMap

Individual provider Active NPI

Lee Kiedrowski, MD

  • Family Medicine Physician
  • Bismarck, ND
National Provider Identifier
1962997338
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RL15208 Issued in ND
Practice address
701 E Rosser Ave
Bismarck, ND 58501-4461
Phone
(701) 751-9500
Fax
(701) 751-9508
NPI assigned
Jun 27, 2018
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL15208 ND Primary

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

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
I20201223001300 ND Practitioner - Family Practice 5890107429 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 5890768006, shared by 5 NPIs, 63 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RL15208NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Dec 21, 2020 Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Nov 3, 2021 Accepting new patients
St. Alexius Medical Center CurrentSince Dec 21, 2020 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Sep 5, 2023 Accepting new patients
McKenzie County Healthcare Systems Inc Family Medicine CurrentSince Sep 5, 2023 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Aug 23, 2021 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Feb 5, 2024 Accepting new patients
St Joseph's Hospital and Health Center Current Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Nov 3, 2021 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Aug 23, 2021 Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
Richardton Health Center, Inc. Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients

Locations

3290 Solutions Ctr
Chicago, IL 60677

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

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

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marian Manor Health Care CenterGlen Ullin, ND, CCN 355036 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2026
Feb 1, 2026
Richardton Health Center, Inc.Richardton, ND, CCN 355122 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control
Adp of the SNF		 Aug 1, 2024
Dec 3, 2024
Dec 10, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

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.

View all 16

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": "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.