NPIMap

Individual provider Active NPI

Jeremy S Kudera, MD

  • Orthopaedic Surgery Physician
  • Yankton, SD
National Provider Identifier
1063433167
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
7840 Issued in SD
Practice address
1104 W 8TH St
Yankton, SD 57078-3306
Phone
(605) 665-7841
NPI assigned
Jul 22, 2006
Last updated
Jun 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 7840 SD Primary

Addresses

Primary practice location

1104 W 8TH St
Yankton, SD 57078-3306

Mailing address

1104 W 8TH St
PO Box 706
Yankton, SD 57078-3306
Phone (605) 665-7841

Other identifiers 3

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN
P00617249OtherMNRAILROAD MEDICARE
896620000MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeremy.kudera@direct.yanktonmedicalclinic.nextgenshare.com Direct

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
I20100908000143 SD Practitioner - Orthopedic Surgery 4284637729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Sanford School of Medicine of University of South Dakota, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yankton Medical Clinic PCGroup PAC ID 1850208778, 59 clinicians
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians

Practice addresses (Care Compare)

1104 W 8TH St
Yankton, SD 57078-3306
Phone (605) 665-7841

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement42
Knee replacement82
Lower limb (leg) arthroscopy (minimally invasive joint repair)20
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yankton Medical Clinic PC Current Accepting new patients
Yankton Medical Clinic PC Current Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Yankton Medical Clinic PC Orthopaedic Surgery CurrentSince Aug 23, 2010 Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Yankton Medical Clinic PC CurrentSince Aug 23, 2010 Accepting new patients
Sacred Heart Health Services Past Accepting new patients

Locations

101 S Plum St
Vermillion, SD 57069
Phone (605) 624-8643

1104 W 8th St
Yankton, SD 57078
Phone (605) 665-7841

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Organizations & group practices 7

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 12

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

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1063433167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "address_2": "PO BOX 706",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDERA",
        "first_name": "JEREMY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SD",
            "license": "7840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00617249",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896620000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeremy.kudera@direct.yanktonmedicalclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1104 W 8th St",
            "city": "Yankton",
            "state": "SD",
            "country_code": "US",
            "postal_code": "570783306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.