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TIOGA MEDICAL CENTER CLINIC
NPI 1245296078
Clinic/Center in Tioga, ND

Active since April 21, 2006
810 N WELO ST, TIOGA, ND 58852(701) 664-3368(701) 664-3300 Get Directions Write a Review

NPPES record last updated: August 30, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tioga Medical Center Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIOGA MEDICAL CENTER CLINIC (NPI 1245296078) is a healthcare organization registered as a clinic/center in Tioga, North Dakota and active in the NPI registry since April 2006. The organization lists Randall K. Pederson, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1245296078
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameTIOGA MEDICAL CENTER
Location Address810 N WELO STTioga, ND 58852-7157
Mailing AddressPo Box 159Tioga, ND 58852-0159 · (701) 664-3368 · Fax (701) 664-3300
Phone(701) 664-3368
Fax(701) 664-3300
Organization SubpartNo
Authorized OfficialRandall K. PedersonPresident/ceo · (701) 664-3305
Enumeration DateApril 21, 2006
Last NPPES UpdateAugust 30, 2016
✔ NPI 1245296078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in ND · 9333
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
810 N WELO ST, Tioga, ND 58852
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Other Names 1

Doing Business AsTioga Medical Center Clinic

Other Identifiers 5

Medicaid10158ND
Other00327001ND · Bcbsnd
Medicare ID-Type UnspecifiedCO4114ND · Railroad Medicare
Other=========001ND · Nd Wsi
Medicare ID-Type UnspecifiedN1000327ND · Nd Medicare B

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tioga Medical Center Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Tioga Medical Center Clinic, which bills Medicare for the services they deliver. Of these, 6 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Jesse Mitchell
Nurse Practitioner
NPI 1417503442
810 N WELO ST
Tioga, ND 58852
(701) 664-3305
✔ PECOS✔ Accepts MedicareSame address
Amber Nelson, FNP-BC
Nurse Practitioner
NPI 1457132649
810 N WELO ST.
Tioga, ND 58852
(701) 664-3305
✔ PECOS✔ Accepts MedicareSame address
Teri Andersen, LPCC
Mental Health Counselor
NPI 1710614250
810 N WELO ST
Tioga, ND 58852
(701) 664-3368
✔ PECOS✔ Accepts MedicareSame address
Kari Ely, FNP-C
Nurse Practitioner
NPI 1962375840
810 N WELO ST
Tioga, ND 58852
(701) 664-3305
✔ PECOS✔ Accepts MedicareSame address
David Petrosian, DO
Family Practice
NPI 1881155745
810 N WELO ST
Tioga, ND 58852
(701) 664-3305
✔ PECOS✔ Accepts MedicareSame address
Jennifer Reynolds
Nurse Practitioner
NPI 1437048410
810 N WELO ST
Tioga, ND 58852
(701) 664-3305
✔ PECOS✔ Accepts MedicareSame address
Mark Peterson, MD
Family Practice
NPI 1134182355
2650 32ND AVE S STE D
Grand Forks, ND 58201
(701) 732-2700
✔ PECOS✔ Accepts Medicare274 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tioga Medical Center's NPI number?

The NPI number for Tioga Medical Center is 1245296078. It was assigned to this organization in the NPPES registry on April 21, 2006. The provider is doing business as Tioga Medical Center Clinic.

Where is Tioga Medical Center located?

Tioga Medical Center is located at 810 N Welo St, Tioga, ND 58852. The listed phone number is (701) 664-3368.

What is Tioga Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Tioga Medical Center enrolled in Medicare?

Yes. Tioga Medical Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tioga Medical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Tioga Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4), Family Practice (2) and Mental Health Counselor (1). Of these, 6 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Tioga Medical Center accept?

Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Tioga Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tioga Medical Center was last updated on August 30, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.