NPIMap

Individual provider Active NPI

Robert Eugene Van Demark III, MD

  • Orthopaedic Surgery Physician
  • Sioux Falls, SD
National Provider Identifier
1063708915
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
10520 Issued in SD
Practice address
1210 W 18TH St Ste G01
Sioux Falls, SD 57104-4651
Phone
(605) 328-2663
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 55491 MN
Orthopaedic Surgery Physician 207X00000X 2016-00257 NC
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 10520 SD Primary

Addresses

Primary practice location

1210 W 18TH St Ste G01
Sioux Falls, SD 57104-4651

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-2663

Other practice location 1

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2966
Phone (704) 631-0002

Other practice location 2

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2966
Phone (704) 631-0002

Other identifiers 2

IdentifierTypeStateIssuer
1063708915MedicaidNC
NC2779MedicaidSC

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
I20171206000473 SD Practitioner - Orthopedic Surgery 1355590597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Creighton University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4651
Phone (605) 328-2663

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-00257NCMDOrthopaedic Surgery Physician
10520SDMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Sep 25, 2017 Accepting new patients
Sanford Medical Center Orthopaedic Surgery CurrentSince Sep 25, 2017 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Sep 25, 2017 Accepting new patients
Sanford Clinic CurrentSince Sep 25, 2017 Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1210 W 18th St
Ste G01
Sioux Falls, SD 57104
Phone (605) 328-1395

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1063708915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-2663",
            "fax_number": "605-312-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST STE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044651",
            "telephone_number": "605-328-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 MOREHEAD MEDICAL DR",
            "address_2": "STE 300",
            "address_purpose": "LOCATION",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042966",
            "country_code": "US",
            "telephone_number": "704-631-0002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 MOREHEAD MEDICAL DR",
            "address_2": "STE 300",
            "address_purpose": "LOCATION",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042966",
            "country_code": "US",
            "telephone_number": "704-631-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DEMARK",
        "first_name": "ROBERT",
        "middle_name": "EUGENE",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "55491",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2016-00257",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SD",
            "license": "10520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063708915",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2779",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.