PAUL R BILSTAD MD
NPI 1033136031
Emergency Medicine - Medical Toxicology in Fargo, ND


Quality Rating: 80.8 out of 100 score

NPI Status: Active since July 16, 2006

Contact Information

801 BROADWAY N
FARGO, ND
ZIP 58102
Phone: (701) 234-5121
Fax: (701) 234-5124

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  • Individual
  • Male
  • Emergency Medicine
  • Medical Toxicology
  • Accepts Insurance
  • PECOS Enrolled

About PAUL BILSTAD

This page provides the complete NPI Profile along with additional information for Paul Bilstad, a provider established in Fargo, North Dakota with a medical specialization in Emergency Medicine, focusing in medical toxicology . The healthcare provider is registered in the NPI registry with number 1033136031 assigned on July 2006. The practitioner's primary taxonomy code is 207PT0002X with license number 8851 (ND). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1033136031
Provider Name
PAUL R BILSTAD MD
Gender
Male
Entity Type
Individual
Location Address
801 BROADWAY N FARGO, ND 58102
Location Phone
(701) 234-5121
Location Fax
(701) 234-5124
Mailing Address
PO BOX 2010 FARGO, ND 58122
Is Sole Proprietor?
No
Enumeration Date
07-16-2006
Last Update Date
03-25-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Emergency Medicine Medical Toxicology

Taxonomy Code
207PT0002X
Type
Allopathic & Osteopathic Physicians
License No.
8851
License State
ND
Taxonomy Description
Medical toxicologists are physicians who specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to drugs and chemicals, as well as biological and radiological agents. Medical toxicologists care for people in clinical, academic, governmental and public health settings, and provide poison control center leadership. Important areas of medical toxicology include acute drug poisoning, adverse drug events, drug abuse, addiction and withdrawal, chemicals and hazardous materials, terrorism preparedness, venomous bites and stings and environmental and workplace exposures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueCare Gold $25 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Silver $45 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueDirect Bronze 100 HSA Eligible ($7500 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
  • BlueEssential Catastrophic 100 $9200 Deductible - PPO
  • BlueValue Bronze $50 PCP Copay (Standardized plan) - PPO
  • BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
  • BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
  • DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
11636MEDICAID (05)ND 

Medicare Participation & PECOS Enrollment Status

Paul Bilstad is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Critical care, first 30-74 minutes

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

This service was performed 28 times for 27 patients

Emergency department visit for life threatening or functioning severity

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

This service was performed 264 times for 252 patients

Emergency department visit for problem of high severity

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

This service was performed 178 times for 162 patients

Emergency department visit for problem of moderate severity

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

This service was performed 30 times for 30 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 58102 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $85.71
  • Minimum New Patient Price $55.75
  • Maximum New Patient Price $168.12
  • Average New Patient Copayment $21.42
  • Minimum New Patient Copayment $13.93
  • Maximum New Patient Copayment $42.03

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $98.29
  • Minimum Established Patient Price $18.11
  • Maximum Established Patient Price $137.65
  • Average Established Patient Copayment $24.57
  • Minimum Established Patient Copayment $4.52
  • Maximum Established Patient Copayment $34.41

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 80.8, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 80.8 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 84.38

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 51.64

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 51.64

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Reviews for PAUL R BILSTAD MD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1033136031
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2063231206
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 6 + 3 + 2 + 3 + 1 + 2 + 0 + 6 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1033136031 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1528062924 MARK F FISHER MD
Individual
Radiology (Diagnostic Radiology)801 BROADWAY N
FARGO, ND 58102
(701) 234-2309
1336146703 SCOTT J FILLMORE MD
Individual
Physical Medicine & Rehabilitation801 BROADWAY N
FARGO, ND 58102
(701) 234-2203
1821062514 JEANNE C DILLON M.D.
Individual
Internal Medicine801 BROADWAY N
FARGO, ND 58102
(701) 234-2261
1184688772 JOHN ALAN PASCHALL MD
Individual
Pediatrics (Pediatric Critical Care Medicine)801 BROADWAY N
FARGO, ND 58102
(701) 234-7428
1528019429 JAMES W NAGLE MD
Individual
Otolaryngology801 BROADWAY N
FARGO, ND 58102
(701) 234-2441
1699727602DR. KENNETH M. GHEEN M.D.
Individual
Pediatrics (Pediatric Critical Care Medicine)801 BROADWAY N
FARGO, ND 58102
(701) 234-7428
1477580074 BRUCE G PITTS MD
Individual
Internal Medicine801 BROADWAY N
FARGO, ND 58102
(701) 234-6707
1194752618 TERRENCE E GRIMM MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)801 BROADWAY N
FARGO, ND 58102
(701) 234-2401
1194754002DR. HONG QI PENG M.D.
Individual
Pathology (Anatomic Pathology)801 BROADWAY N
FARGO, ND 58102
(701) 234-2469
1023049129 CONRAD R TONI MD
Individual
Urology (Pediatric Urology)801 BROADWAY N
FARGO, ND 58102
(701) 234-2301
1821020066 STEPHEN J SPELLMAN MD
Individual
Internal Medicine (Gastroenterology)801 BROADWAY N
FARGO, ND 58102
(701) 234-2525
1306863394 BRUCE A ASLESON MD
Individual
Radiology (Diagnostic Radiology)801 BROADWAY N
FARGO, ND 58102
(701) 234-4811
1568489565 JOHN L CRARY MD
Individual
Internal Medicine (Cardiovascular Disease)801 BROADWAY N
FARGO, ND 58102
(701) 234-2371
1215954177 JACOB A GOLDENBERG MD
Individual
Radiology (Diagnostic Radiology)801 BROADWAY N
FARGO, ND 58102
(701) 234-2461
1467479139 REGIS GARY LAGLER MD
Individual
Internal Medicine (Critical Care Medicine)801 BROADWAY N
FARGO, ND 58102
(701) 234-7200
1124045760 MARGARET TRAYNOR MICKELSON MD
Individual
Obstetrics & Gynecology801 BROADWAY N
FARGO, ND 58102
(701) 234-2241
1437176906 MANUEL R OTERO-CAGIDE MD
Individual
Internal Medicine (Cardiovascular Disease)801 BROADWAY N
FARGO, ND 58102
(701) 234-2371
1801814447 THOMAS L HERZOG MD
Individual
Obstetrics & Gynecology801 BROADWAY N
FARGO, ND 58102
(701) 234-2241
1063430619 JONATHAN L DICKSON MD
Individual
Internal Medicine (Cardiovascular Disease)801 BROADWAY N
FARGO, ND 58102
(701) 234-2000
1801814413 RICHARD J MARSDEN MD
Individual
Radiology (Neuroradiology)801 BROADWAY N
FARGO, ND 58102
(701) 234-5015

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033136031, enumerated in the NPI registry as an "individual" on July 16, 2006

The provider is located at 801 Broadway N Fargo, Nd 58102 and the phone number is (701) 234-5121

The provider's speciality is Emergency Medicine with taxonomy code 207PT0002X with a focus in Medical Toxicology

The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota, Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $85.71 with an average copayment of $21.42 for new patient appointments. Established patients should expect a typical charge of $98.29 and an average copayment of 24.57. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Critical care, first 30-74 minutes, Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity and Emergency department visit for problem of moderate severity.

This NPI record was last updated on July 16, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.