Individual provider Active NPI

Mark James Jameson, MD PHD

  • Otolaryngology Physician
  • Sioux Falls, SD
National Provider Identifier
1073564993
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
13192 Issued in SD
Practice address
1417 S Cliff Ave Ste 300
Sioux Falls, SD 57105-1062
Phone
(605) 504-3000
Fax
(605) 504-3001
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101241309 VA
Otolaryngology Physician 207Y00000X 13192 SD Primary

Addresses

Primary practice location

1417 S Cliff Ave Ste 300
Sioux Falls, SD 57105-1062

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
0487819MedicaidIA
1073564993MedicaidVA
P00347197OtherIAMEDICARE RAILROAD
20003OtherIAWELLMARK BCBS

Other names 1

  • Mark James Horney Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjameson6746@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070912000360 VA Practitioner - Otolaryngology 7416967088 Reassigns benefits to 1 organization
I20220224002633 SD Practitioner - Otolaryngology 7416967088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2114

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

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

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Pipestone County Medical Center Hospital, Pipestone, MN, CCN 241374
  • Avera Marshall Regional Medical Ctr Hospital, Marshall, MN, CCN 241359
  • Avera St Lukes Hospital, Aberdeen, SD, CCN 430014
  • Lakes Regional Healthcare Hospital, Spirit Lake, IA, CCN 160124

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision33
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13192SDMDOtolaryngology Physician
0101241309VAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Feb 1, 2022 Accepting new patients
Avera McKennan CurrentSince Feb 1, 2022 Accepting new patients
Avera McKennan Current Accepting new patients
University of Virginia Physicians Group CurrentSince Jul 1, 2007 Accepting new patients

Locations

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

415 Ray C Hunt Dr
#2200
Charlottesville, VA 22903

415 Ray C Hunt Dr
Ste 2200
Charlottesville, VA 22903
Phone (434) 924-2153

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: mark.jameson@avera.sdhealthlink.net
  • Direct secure messaging: mjameson6746@direct.healthsystem.virginia.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1073564993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE STE 300",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051062",
            "telephone_number": "605-504-3000",
            "fax_number": "605-504-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE STE 300",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051062",
            "telephone_number": "605-504-3000",
            "fax_number": "605-504-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMESON",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101241309",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SD",
            "license": "13192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487819",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073564993",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00347197",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "20003",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjameson6746@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "415 Ray C Hunt Dr Ste 2200",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229032980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "HORNEY",
            "middle_name": "JAMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.