| Mark S Kristy, MD | |
|
1000 Highway 12, Hettinger, ND 58639-7530 | |
| (701) 567-4561 | |
| (701) 567-6363 |
| Full Name | Mark S Kristy |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 36 Years |
| Location | 1000 Highway 12, Hettinger, North Dakota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609974195 | NPI | - | NPPES |
| 7781732 | Medicaid | SD | |
| 13032 | Other | ND | BC/BS |
| 4503468812 | Medicaid | NE | |
| 1914556 | Medicaid | IA | |
| A13801044310 | Other | PREFERREDONE | |
| 658162-00 | Medicaid | MN | |
| 18409 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 7219 (North Dakota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West River Regional Medical Center | Hettinger, ND | Hospital |
| Chi St Alexius Health | Bismarck, ND | Hospital |
| Smp Health St Aloisius | Harvey, ND | Hospital |
| Garrison Memorial Hospital | Garrison, ND | Hospital |
| Southwest Healthcare Services | Bowman, ND | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| West River Health Services | 0042127045 | 18 |
| St Alexius Medical Center | 8426960865 | 239 |
| Entity Name | St Alexius Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205868429 PECOS PAC ID: 8426960865 Enrollment ID: O20031104000146 |
| Entity Name | West River Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174606271 PECOS PAC ID: 0042127045 Enrollment ID: O20040128001023 |
| Entity Name | West River Health Services |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1588763247 PECOS PAC ID: 0042127045 Enrollment ID: O20100909000218 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark S Kristy, MD 1000 Highway 12, Hettinger, ND 58639-7530 Ph: (701) 567-4561 | Mark S Kristy, MD 1000 Highway 12, Hettinger, ND 58639-7530 Ph: (701) 567-4561 |