ILENE BRACKIN PA-C
NPI 1457451981
Physician Assistant - Surgical in Bismarck, ND

Q: What is Ilene Brackin's NPI number?

The NPI number for Ilene Brackin is 1457451981. It was assigned to this individual provider in the NPPES registry on September 24, 2006.

Q: What is Ilene Brackin's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Ilene Brackin was last updated on December 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since September 24, 2006PECOS EnrolledAccepts Medicare Assignment

310 N 10TH ST, BISMARCK, ND 58501(701) 530-7500(701) 530-7484 Get Directions Write a Review

NPPES record last updated: December 28, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 11, 2023, Jun 25, 2021 (2 updates tracked since 2021).

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About Ilene Brackin Pa-c NPPES

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

ILENE BRACKIN PA-C (NPI 1457451981) is an individual surgical provider in Bismarck, North Dakota, licensed in North Dakota (PAC0236) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Essentia Health St Marys - Detroit Lakes, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1457451981

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameILENE BRACKINCredential: PA-C

Location Address310 N 10TH STBismarck, ND 58501-4516

Mailing Address310 N 10th StBismarck, ND 58501-4516 · (701) 530-7500 · Fax (701) 530-7484

Phone(701) 530-7500

Fax(701) 530-7484

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateSeptember 24, 2006

Last NPPES UpdateDecember 28, 20232 updates tracked since enumeration

NPPES CertifiedDecember 28, 2023

✔ NPI 1457451981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in ND · PAC0236

Also ListedPhysician AssistantTaxonomy 363A00000X · License PAC0236 (ND)

310 N 10TH ST, Bismarck, ND 58501

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Secondary Practice Locations 2

Location 1101 3rd Ave SWMinot, ND 58701-3880 · Phone (701) 857-3655

Location 22305 37th Ave SWMinot, ND 58701-7669 · Phone (701) 857-5000

Other Identifiers 2

OtherP00210194ND · Railroad Medicare

Other1457451981ND · Npi

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ilene Brackin Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476511528

PECOS Enrollment IDI20041221000845

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Essentia Health St Marys - Detroit Lakes

Acute Care Hospitals · Detroit Lakes, MN

OwnershipVoluntary non-profit - Church

CMS Certification Number240101

Location1027 Washington AveDetroit Lakes, MN 56501 · Becker County

Birthing friendly

Essentia Health

Acute Care Hospitals · Fargo, ND

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number350070

Location3000 32nd Ave SouthFargo, ND 58104 · Cass County

Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers15 claims15 services$106.55 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANETTE PENGILLY GNP-C

Nurse Practitioner (Gerontology)