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 11 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Peterson Medical Clinics Llc, Peterson Medical Clinics Llc, Peterson Medical Clinics Llc, Yukon-kuskokwim Health Corporation, Bristol Bay Area Health Corporation 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
Experience11 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: 07/18/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9032332275
  • Enrollment ID: I20200201000273

Medical Identifiers

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

Medical Taxonomies and Licenses

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

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Peterson Medical Clinics Llc933541222051
Peterson Medical Clinics Llc933541222051
Peterson Medical Clinics Llc933541222051
Yukon-kuskokwim Health Corporation519371876577
Bristol Bay Area Health Corporation589069992059

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 NameIdeal Option Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457788275
PECOS PAC ID: 6709013105
Enrollment ID: O20160929000987
Entity NameIdeal Telemedicine Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346754868
PECOS PAC ID: 2860726221
Enrollment ID: O20190708000200
Entity NamePeterson Medical Clinics Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699295774
PECOS PAC ID: 9335412220
Enrollment ID: O20240502002314

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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Practice Location: 1000 S Columbia Rd, Grand Forks, ND 58201
Phone: 701-780-5000    
Bethann Marie Nuelle, FNP-C
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Practice Location: 4700 S Washington St, Grand Forks, ND 58201
Phone: 701-757-2559    
Ms. Mary Pat Holler-bibel, FNP
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Medicare: Accepting Medicare Assignments
Practice Location: 718 Oak St, Grand Forks, ND 58201
Phone: 218-230-0070    Fax: 800-958-7702
Kayla Clausen, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 960 S Columbia Rd, Grand Forks, ND 58201
Phone: 701-780-5400    Fax: 701-780-6416
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
Ethan Lee Thomas, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 4440 S. Washington St., Grand Forks, ND 58201
Phone: 701-732-7000    
Kamrin L Macki, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 4440 S Washington St - Altru Professional Center, Grand Forks, ND 58201
Phone: 701-732-7000    

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.