Dolores I Van Bourgondien, ANP-BC - Medicare Nurse Practitioner in Grand Forks, ND

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Dolores I Van Bourgondien, ANP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Grand Forks, North Dakota. She graduated from nursing school in 2013 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Kenaitze Indian Tribe, Peterson Medical Clinics Llc, Peterson Medical Clinics Llc, Peterson Medical Clinics Llc, Peterson Medical Clinics Llc, Bristol Bay Area Health Corporation, Peterson Medical Clinics Llc and her current practice location is 4700 S Washington St Ste G, Grand Forks, North Dakota. You can reach out to her office (for appointments etc.) via phone at (701) 205-3000.

Dolores I Van Bourgondien is licensed to practice in North Dakota (license number R54243) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457788390.

Contact Information

Dolores I Van Bourgondien, ANP-BC
4700 S Washington St Ste G,
Grand Forks, ND 58201-8155
(701) 205-3000
(701) 732-2501

Map and Direction




Provider's Profile

Full NameDolores I Van Bourgondien
GenderFemale
SpecialityNurse Practitioner
Experience12 Years
Location4700 S Washington St Ste G, Grand Forks, North Dakota
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dolores I Van Bourgondien graduated from nursing school in 2013
  NPI Data:
  • NPI Number: 1457788390
  • Provider Enumeration Date: 10/10/2013
  • Last Update Date: 05/02/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 9032332275
  • Enrollment ID: I20190610000219

Medical Identifiers

Medical identifiers for Dolores I Van Bourgondien such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457788390NPI-NPPES
1695195MedicaidAK
010140700MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2200XNurse Practitioner - Adult Health ARNP9239798 (Florida)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health R54243 (North Dakota)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Kenaitze Indian Tribe408250622518
Peterson Medical Clinics Llc933541222068
Peterson Medical Clinics Llc933541222068
Peterson Medical Clinics Llc933541222068
Peterson Medical Clinics Llc933541222068
Bristol Bay Area Health Corporation589069992089
Peterson Medical Clinics Llc933541222068

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dolores I Van Bourgondien allows following entities to bill medicare on her behalf.
Entity NameNorton Sound Health Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154358232
PECOS PAC ID: 7517858137
Enrollment ID: O20040323001076
Entity NameKenaitze Indian Tribe
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932114600
PECOS PAC ID: 4082506225
Enrollment ID: O20040325000198
Entity NameNorton Sound Health Corporation
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1225101041
PECOS PAC ID: 7517858137
Enrollment ID: O20080227000439

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dolores I Van Bourgondien is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dolores I Van Bourgondien, ANP-BC
Po Box 5210,
Grand Forks, ND 58206-5210

Ph: () -		Dolores I Van Bourgondien, ANP-BC
4700 S Washington St Ste G,
Grand Forks, ND 58201-8155

Ph: (701) 205-3000

Reviews and Comments


Nurse Practitioner Nurses in Grand Forks, ND

Ms. Estella Ann Boger, GNP-C
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Bethann Marie Nuelle, FNP-C
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Practice Location: 4700 S Washington St, Grand Forks, ND 58201
Phone: 701-757-2559    
Kaitlyn Rose Vagle, FNP
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Practice Location: 1200 S Columbia Rd, Grand Forks, ND 58201
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Ms. Mary Pat Holler-bibel, FNP
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Practice Location: 718 Oak St, Grand Forks, ND 58201
Phone: 218-230-0070    Fax: 800-958-7702
Kayla Clausen, FNP-C
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Medicare: Accepting Medicare Assignments
Practice Location: 960 S Columbia Rd, Grand Forks, ND 58201
Phone: 701-780-5400    Fax: 701-780-6416
Kelsey Vivatson, PMHNP-BC, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2534 17th Ave S Ste E, Grand Forks, ND 58201
Phone: 701-885-4551    Fax: 701-757-1351
Laura Olson,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1300 S Columbia Rd, Grand Forks, ND 58201
Phone: 701-780-2300    Fax: 701-780-6940

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.