The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Devils Lake and North Dakota

1 active clinicians are listed under Behavior Analyst with a practice address in Devils Lake, ND (100 in North Dakota).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-04-19

Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Technician - Personal Care Attendant

NUCC Taxonomy Code: 3747P1801X

An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards

Technician - Personal Care Attendant

NUCC Taxonomy Code: 3747P1801X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: North Dakota State Medical Licensing Board.

Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Qsp

1780440968 (ND)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 15, 2024

Technician

✅

NPI Profile Active February 26, 2024

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) February 26, 2024

Registered at 410 7TH AVE S, DEVILS LAKE, ND 58301 (Tel: 7012303726)

📍

Business Mailing Address (Initial Record) February 26, 2024

Registered at 410 7TH AVE SE, DEVILS LAKE, ND 583013700 (Tel: 7012303726)

👤

Provider Name / Credentials (Initial Record) February 26, 2024

Recorded as SERENA EAGLE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 26, 2024

Behavior Analyst

🟢

Initial NPI Registration & Enumeration February 26, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1780440966

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 26, 2024

Last Update: April 19, 2024

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

410 7th Ave Se

Devils Lake, ND 583013700

Phone: 7012303726

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.