NPIMap

Individual provider Active NPI

Karissa G Zimmer, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1033551114
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0876 Issued in SD
Practice address
2315 W. 57TH Street
Suite 300
Sioux Falls, SD 57108
Phone
(615) 271-5441
Fax
(605) 271-5277
NPI assigned
Jul 18, 2013
Last updated
Feb 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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 0876 SD Primary

Addresses

Primary practice location

2315 W. 57TH Street
Suite 300
Sioux Falls, SD 57108

Mailing address

2315 W. 57TH Street
Suite 300
Sioux Falls, SD 57108
Phone (615) 271-5441

Other identifiers 1

IdentifierTypeStateIssuer
1033551114MedicaidSD

Other names 1

  • Karissa G Miller Former name

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
I20140123000790 SD Practitioner - Physician Assistant 2860620754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

521 N Main Ave
Suite 100
Sioux Falls, SD 57104-5947

910 E 20TH St
Sioux Falls, SD 57105-1012

PO Box
Sioux Falls, SD 57118-6370

PO Box
Suite 1460
Aberdeen, SD 57402-1460

PO Box
Suite 3100
Carbondale, IL 62902

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince May 20, 2024 Accepting new patients
Avera McKennan CurrentSince May 20, 2024 Accepting new patients
City of Sioux Falls CurrentSince Nov 4, 2013 Accepting new patients
Storm Clinic, Prof. LLC PastSince May 15, 2017 Accepting new patients

Locations

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

521 N Main Ave
Ste 100
Sioux Falls, SD 57104
Phone (605) 367-8029

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1033551114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 W. 57TH STREET",
            "address_2": "SUITE 300",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57108",
            "telephone_number": "615-271-5441",
            "fax_number": "605-271-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 W. 57TH STREET",
            "address_2": "SUITE 300",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57108",
            "telephone_number": "615-271-5441",
            "fax_number": "605-271-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "KARISSA",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033551114",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "MILLER",
            "middle_name": "G",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.