NPIMap

Organization Active NPI

Avera St. Luke's

Doing business as Avera Medical Group Pain Management Aberdeen

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Aberdeen, SD
National Provider Identifier
1083051817
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
AVERA ST. LUKE'S
Doing business as
Avera Medical Group Pain Management Aberdeen
Avera Pain Management Aberdeen
Avera Physical Medicine & Rehabilitation Aberdeen
Practice address
820 1St Ave SE Ste 200
Aberdeen, SD 57401-4604
Phone
(605) 622-5123
Fax
(605) 622-5906
NPI assigned
Jun 3, 2013
Last updated
Apr 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Daniel J Bjerknes
Title
President/Ceo
Phone
(605) 622-5125

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X

Addresses

Primary practice location

820 1St Ave SE Ste 200
Aberdeen, SD 57401-4604

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-4933

Other practice location 1

820 1st Ave SE Ste 200
Aberdeen, SD 57401-4604
Phone (605) 622-5123

Other names 3

  • Avera Medical Group Pain Management Aberdeen Doing business as
  • Avera Pain Management Aberdeen Doing business as
  • Avera Physical Medicine & Rehabilitation Aberdeen Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000912 SD Part B Supplier - Clinic/Group Practice 6406764927 Receives reassigned benefits from 271 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, SD; Waubay, SD; Redfield, SD; Mobridge, SD; Groton, SD; Faulkton, SD; Britton, SD

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Tax ID family
Amg Radiology25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

820 1st Ave SE
Ste 200
Aberdeen, SD 57401
Phone (605) 622-5123

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1083051817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-4933",
            "fax_number": "605-504-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 1ST AVE SE STE 200",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014604",
            "telephone_number": "605-622-5123",
            "fax_number": "605-622-5906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 1st Ave SE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574014604",
            "country_code": "US",
            "telephone_number": "605-622-5123",
            "fax_number": "605-622-5906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVERA ST. LUKE'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "BJERKNES",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-622-5125"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Pain Management Aberdeen",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Pain Management Aberdeen",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Physical Medicine & Rehabilitation Aberdeen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.