Summary of Physician Assistant Licensure Requirements

To become eligible to practice as a physician assistant in North Dakota, the PA:

  1. Must provide evidence of completing/graduating from a physician assistant program;
  2. Must have passed the certifying examination of the National Commission on Certification of Physician Assistants;
  3. Must provide evidence of current "good standing" with the National Commission on Certification of Physician Assistants, and;
  4. Must secure a contract to provide patient services under the supervision of a doctor of medicine or osteopathy who practices medicine in North Dakota and who is responsible for the performance of the physician assistant.

Instructions

  1. Complete every section of the online application.
    1. $55.00 application fee payable by credit card.
  2. Documents needing to be uploaded or mailed to the North Dakota Board of Medicine:
    1. A photocopy of your diploma from your PA program.
    2. A photocopy of your NCCPA Wall Certificate.
    3. A recent 2"x3" unmounted photo of yourself. If you choose to submit a paper photograph please follow these instructions:

      The photo must be:
      1. Original passport quality photograph. No computer scanned or polaroid photograph with thick backing.
      2. Close-up front view of head and shoulders no larger than 2" X 3" and no smaller than 2" X 2".
      3. Must have been taken within 90-120 days prior of submitting this application.
    4. You must complete and submit the Criminal History Record Check Request form and two fingerprint cards along with a money order of $40.00 made payable to the Office of the Attorney General. Mail completed fingerprint cards along with the money order to the North Dakota Board of Medicine: 418 E. Broadway Suite 12, Bismarck, ND 58501.

      You should call your local law enforcement office for times and locations that fingerprinting services are available. Be sure to bring a photo ID. A small fee may be required.

      DO NOT BEND OR FOLD the fingerprint cards when mailing them to us as they will be rejected and you will be required to be fingerprinted again. Be sure all personal information is completed on the cards. Click here for instructions and example.
    5. The completed and signed Supervision Contract form.
    6. You must direct the licensing board of each state/province where you have ever applied for any type of physician assistant license (regardless of whether the license was granted or not granted, is active or inactive, temporary or permanent, restricted or unrestricted) to provide the North Dakota Board of Medicine with verification of your licensure status.
    7. Delegation of Prescriptive Authority completed and signed by primary supervising physician.
  3. Processing of your application will be faster if you upload where ever possible.
  4. Please keep a copy of the completed contract and application forms for your own files.

Click here to begin the online application process.

If you prefer you may submit a paper application form, click here to download the application form (22 KB PDF). Please submit the completed form with $50.00 application fee payable by check or money order only in U.S. currency to the ND Board of Medicine.

Interviews

Any applicant may be required to appear before the Board of Medicine for an interview. An applicant should expect to appear for an interview if any derogatory information is brought to the attention of the Board during the application process.