Individual provider Active NPI

Tage Elizabeth Born, MD

  • Obstetrics & Gynecology Physician
  • Aberdeen, SD
National Provider Identifier
1063596245
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3807 Issued in SD
Practice address
310 S Penn St
Suite 204
Aberdeen, SD 57401
Phone
(605) 225-1636
Fax
(605) 229-2434
NPI assigned
Oct 25, 2006
Last updated
Jan 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 3807 SD Primary

Addresses

Primary practice location

310 S Penn St
Suite 204
Aberdeen, SD 57401

Mailing address

310 S Penn St
Suite 204
Aberdeen, SD 57401
Phone (605) 225-1636

Other identifiers 1

IdentifierTypeStateIssuer
6200220MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060316000108 SD Practitioner - Obstetrics/Gynecology 2961419916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Sanford School of Medicine of University of South Dakota, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

310 S Penn St
Suite 204
Aberdeen, SD 57401-4553
Phone (605) 225-1636

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Luke's Current Accepting new patients
Avera St. Lukes CurrentSince Jan 1, 2010 Accepting new patients
Avera St. Luke's CurrentSince Jan 1, 2010 Accepting new patients

Locations

201 S Lloyd St
Ste 240
Aberdeen, SD 57401
Phone (605) 225-1636

201 S Lloyd St
Ste E206
Aberdeen, SD 57401
Phone (605) 225-1636

305 S State St
Aberdeen, SD 57401
Phone (605) 229-3000

310 S Pennsylvania St
Ste 204
Aberdeen, SD 57401
Phone (605) 225-1636

Interoperability endpoints

  • Direct secure messaging: tage.born@avera.sdhealthlink.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1063596245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S PENN ST",
            "address_2": "SUITE 204",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "57401",
            "telephone_number": "605-225-1636",
            "fax_number": "605-229-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S PENN ST",
            "address_2": "SUITE 204",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "57401",
            "telephone_number": "605-225-1636",
            "fax_number": "605-229-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORN",
        "first_name": "TAGE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SD",
            "license": "3807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6200220",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.