Individual provider Active NPI

Jacob Grass, AUD

  • Audiologist
  • Sioux Falls, SD
National Provider Identifier
1053160069
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1417 S Cliff Ave Plaza 1 Suite 300
Sioux Falls, SD 57105
Phone
(605) 504-3020
NPI assigned
May 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

1417 S Cliff Ave Plaza 1 Suite 300
Sioux Falls, SD 57105

Mailing address

15 Forest Ave
Vermillion, SD 57069-3105
Phone (605) 391-1668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808000591 SD Practitioner - Qualified Audiologist 2567909534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1417 S Cliff Ave
Suite 300
Sioux Falls, SD 57105-1062
Phone (605) 504-3000

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince May 20, 2024 Accepting new patients
Avera McKennan CurrentSince May 20, 2024 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

1417 S Cliff Ave
Ste 300
Sioux Falls, SD 57105
Phone (605) 322-8630

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1053160069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FOREST AVE",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693105",
            "telephone_number": "605-391-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE PLAZA 1 SUITE 300",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57105",
            "telephone_number": "605-504-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASS",
        "first_name": "JACOB",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.