NPIMap

Individual provider Active NPI

Justin A Clem, M.D.

  • Family Medicine Physician
  • Madison, SD
National Provider Identifier
1083050827
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9998 Issued in SD
Practice address
323 10TH St SW
Madison, SD 57042-3200
Phone
(605) 256-6551
Fax
(605) 255-6409
NPI assigned
May 20, 2013
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9998 SD Primary

Addresses

Primary practice location

323 10TH St SW
Madison, SD 57042-3200

Mailing address

323 10TH St SW
Madison, SD 57042-3200
Phone (605) 256-6551

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
I20160926001921 SD Practitioner - Family Practice 7719116086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Community HospitalGroup PAC ID 3779579743, 46 clinicians

Practice addresses (Care Compare)

323 SW 10TH St
Madison, SD 57042-3200
Phone (605) 256-6551

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.71 of 100Reported as group
Quality
85.75
Improvement activities
40
Cost
78.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9998SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Community Hospital CurrentSince Sep 13, 2016 Accepting new patients
Madison Community Hospital CurrentSince Sep 13, 2016 Accepting new patients
Bethel Lutheran Home Past Accepting new patients

Locations

323 SW 10th St
Madison, SD 57042
Phone (605) 256-6551

Interoperability endpoints

  • Direct secure messaging: jclem739617@direct.ochin.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bethel Lutheran HomeMadison, SD, CCN 435076 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control
Adp of the SNF
Indirect Ownership Interest		 Jul 11, 2018
Dec 13, 2024
Dec 20, 2024
Jul 11, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Bethel Lutheran Home
    • Skilled Nursing Facility
    • Madison, SD
    • NPI 1497736615

    Adp of the SNF, Contracted Managing Employee, Indirect Ownership Interest, Operational/Managerial Control

    CMS ownership

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1083050827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 10TH ST SW",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "570423200",
            "telephone_number": "605-256-6551",
            "fax_number": "605-255-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 10TH ST SW",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "570423200",
            "telephone_number": "605-256-6551",
            "fax_number": "605-255-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "JUSTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "9998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, SD

Sources for this page

Verify at the official NPI Registry.