NPIMap

Individual provider Active NPI

Wesley L Sufficool, DO

  • Surgery Physician
  • Rapid City, SD
National Provider Identifier
1043309891
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4023 Issued in SD
Practice address
211 Founders Park Dr Ste 2
Rapid City, SD 57701-8099
Phone
(605) 791-5553
Fax
(605) 791-5644
NPI assigned
Oct 12, 2006
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4023 SD Primary

Addresses

Primary practice location

211 Founders Park Dr Ste 2
Rapid City, SD 57701-8099

Mailing address

211 Founders Park Dr Ste 2
Rapid City, SD 57701-8099
Phone (605) 791-5553

Other identifiers 1

IdentifierTypeStateIssuer
P00416084OtherSDRR MEDICARE

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
I20050714000424 SD Practitioner - General Surgery 5294620530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

211 Founders Park Dr
Suite 2
Rapid City, SD 57701-8099
Phone (605) 791-5553

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy21
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4023SDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fall River Health Services Current Accepting new patients
Black Hills Dialysis, LLC PastSince Apr 30, 2003 Accepting new patients
Medical Associates of the Black Hillc, LLC. Surgery Past Accepting new patients

Locations

1201 Highway 71 S
Hot Springs, SD 57747
Phone (605) 745-3159

Interoperability endpoints

  • Direct secure messaging: wesley.sufficool@ssp-sd.direct.office.nextgen.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Same Day Surgery Center LLCRapid City, SD, CCN 430093 Hospital 5% Or Greater Direct Ownership Interest (6.52%)
5% Or Greater Indirect Ownership Interest (10.87%)
Limited Partnership Interest (6.52%)
Corporate Officer (7%)		 Apr 1, 2019
May 1, 2019
Apr 1, 2019
Jan 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Same Day Surgery Center LLC
    • Special Hospital
    • Rapid City, SD
    • NPI 1407819253

    5% Or Greater Direct Ownership Interest, 5% Or Greater Indirect Ownership Interest, Corporate Officer, Limited Partnership Interest

    CMS ownership

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1043309891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FOUNDERS PARK DR STE 2",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018099",
            "telephone_number": "605-791-5553",
            "fax_number": "605-791-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FOUNDERS PARK DR STE 2",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018099",
            "telephone_number": "605-791-5553",
            "fax_number": "605-791-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFFICOOL",
        "first_name": "WESLEY",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "4023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00416084",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.