NPIMap

Individual provider Active NPI

Bradley Clark Thaemert, MD

  • Surgery Physician
  • Sioux Falls, SD
National Provider Identifier
1083688279
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4414 Issued in SD
Practice address
911 E 20TH St
Ste 700
Sioux Falls, SD 57105-1049
Phone
(605) 334-0393
Fax
(605) 334-6028
NPI assigned
Feb 14, 2006
Last updated
Jun 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4414 SD Primary
Surgery Physician 208600000X 41537 MN

Addresses

Primary practice location

911 E 20TH St
Ste 700
Sioux Falls, SD 57105-1049

Mailing address

911 E 20TH St
Ste 700
Sioux Falls, SD 57105-1049
Phone (605) 334-0393

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
I20101123001236 SD Practitioner - General Surgery 2567351810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Institute of South Dakota PCGroup PAC ID 7911896253, 22 clinicians

Practice addresses (Care Compare)

1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 322-8000

910 E 20TH St
Sioux Falls, SD 57105-1012
Phone (605) 334-6730

911 E 20TH St
Suite 700
Sioux Falls, SD 57105-1049
Phone (605) 334-0393

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion119
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)15
Upper gastrointestinal (GI) endoscopy for acid reflux64
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41537MNMDSurgery Physician
4414SDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Institute of South Dakota, PC Surgery CurrentSince Jul 15, 1998 Accepting new patients
Avera McKennan Past Accepting new patients

Locations

910 E 20th St
Sioux Falls, SD 57105
Phone (602) 338-7098

911 E 20th St
Ste 700
Sioux Falls, SD 57105
Phone (605) 322-7300

911 E 20th St
Ste 800
Sioux Falls, SD 57105
Phone (605) 334-2266

Interoperability endpoints

  • Direct secure messaging: bradley.thaemert@avera.sdhealthlink.net

Organizations & group practices 2

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1083688279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 E 20TH ST",
            "address_2": "STE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051049",
            "telephone_number": "605-334-0393",
            "fax_number": "605-334-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E 20TH ST",
            "address_2": "STE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051049",
            "telephone_number": "605-334-0393",
            "fax_number": "605-334-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAEMERT",
        "first_name": "BRADLEY",
        "middle_name": "CLARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "4414",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "41537",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.