MALLORY HESTDALEN
NPI 1851752885
Nurse Practitioner - Neonatal in Fargo, ND

Q: What is Mallory Hestdalen's NPI number?

The NPI number for Mallory Hestdalen is 1851752885. It was assigned to this individual provider in the NPPES registry on March 18, 2016.

Q: What is Mallory Hestdalen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Hestdalen was last updated on September 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 March 18, 2016PECOS Enrolled

801 BROADWAY N, FARGO, ND 58102(701) 234-2000 Get Directions Write a Review

NPPES record last updated: September 29, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 29, 2020, Mar 18, 2016 (2 updates tracked since 2016).

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About Mallory Hestdalen NPPES

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

MALLORY HESTDALEN (NPI 1851752885) is an individual neonatal provider in Fargo, North Dakota, licensed in North Dakota (R33463) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851752885

Entity TypeIndividualFemale

Primary Taxonomy363LN0000X

Provider Legal NameMALLORY HESTDALEN

Location Address801 BROADWAY NFargo, ND 58102-3641

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074

Phone(701) 234-2000

Sole ProprietorNo

Enumeration DateMarch 18, 2016

Last NPPES UpdateSeptember 29, 20202 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2020

✔ NPI 1851752885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · NeonatalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LN0000X

License✔ Licensed in ND · R33463

Also ListedRegistered NurseTaxonomy 163W00000X · License R33463 (ND)

801 BROADWAY N, Fargo, ND 58102

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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 (PECOS)

Mallory Hestdalen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $55.75 – $168.12

Typical copayment $21.42 (range $13.93 – $42.03)

Most-billed visit code 99203

Established Patient

$98.29 typical visit price

range $18.11 – $137.65

Typical copayment $24.57 (range $4.52 – $34.41)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

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