NPIMap

Individual provider Active NPI

Misty Rudebusch, PA-C

  • Physician Assistant
  • Howard, SD
National Provider Identifier
1013987478
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
448 Issued in SD
Practice address
213 S Main
Howard, SD 57349
Phone
(605) 772-4426
Fax
(605) 772-4261
NPI assigned
Jan 26, 2006
Last updated
Nov 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 448 SD Primary

Addresses

Primary practice location

213 S Main
Howard, SD 57349

Mailing address

213 S Main
Howard, SD 57349
Phone (605) 772-4426

Other identifiers 9

IdentifierTypeStateIssuer
4995481OtherSDWELLMARK
5300492MedicaidSD
9235848OtherSDDAKOTACARE
AH1341033452OtherSDPREFERRED ONE
P00183707OtherSDRR MEDICARE
1107619OtherSDAMERICA'S PPO
243580OtherSDMIDLAND'S CHOICE
01-18249OtherSDMEDICA
S1639OtherSDMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518000598 SD Practitioner - Physician Assistant 3476543620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Health Care IncGroup PAC ID 8921997933, 55 clinicians

Practice addresses (Care Compare)

208 S Main
Howard, SD 57349-0099
Phone (605) 772-4574

401 Prairie Ave SW
Desmet, SD 57231-2224
Phone (605) 854-3455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0448SDMDOccupational Therapist
448SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health Care Inc CurrentSince Nov 20, 2016 Accepting new patients
Horizon Health Care Inc CurrentSince Nov 20, 2016 Accepting new patients
Horizon Health Care Inc Physician Assistant Past Accepting new patients
Avera Queen of Peace Past Accepting new patients

Locations

602 1st St NE
Ste 1
Wessington Springs, SD 57382
Phone (605) 539-1778

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1013987478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S MAIN",
            "city": "HOWARD",
            "state": "SD",
            "postal_code": "57349",
            "telephone_number": "605-772-4426",
            "fax_number": "605-772-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S MAIN",
            "city": "HOWARD",
            "state": "SD",
            "postal_code": "57349",
            "telephone_number": "605-772-4426",
            "fax_number": "605-772-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDEBUSCH",
        "first_name": "MISTY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "4995481",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5300492",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9235848",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "AH1341033452",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00183707",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "1107619",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE",
            "identifier": "243580",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-18249",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S1639",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard, SD

Sources for this page

Verify at the official NPI Registry.