Individual provider Active NPI

Liesl Pavlic, MD

  • Internal Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1124287859
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16948 Issued in SD
Practice address
300 N Dakota Ave Ste 117
Sioux Falls, SD 57104-6020
Phone
(605) 322-6800
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16948 SD Primary

Addresses

Primary practice location

300 N Dakota Ave Ste 117
Sioux Falls, SD 57104-6020

Mailing address

300 N Dakota Ave Ste 117
Sioux Falls, SD 57104-6020
Phone (605) 322-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, 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
I20221115000721 AL Practitioner - Internal Medicine 3577611649 Reassigns benefits to 2 organizations
I20251203001190 SD Practitioner - Internal Medicine 3577611649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Sioux Falls, SD 57118-6370

PO Box
Suite 86370
Sioux Falls, SD 57118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16948SDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Internal Medicine CurrentSince Sep 5, 2025 Accepting new patients
HH Physician Care Internal Medicine CurrentSince Oct 15, 2023 Accepting new patients
Physynergy, LLC CurrentSince Mar 14, 2023 Accepting new patients
Physynergy, LLC Current Accepting new patients
Avera McKennan CurrentSince Sep 5, 2025 Accepting new patients
Avera McKennan Current Accepting new patients
Physynergy, LLC CurrentSince Mar 14, 2023 Accepting new patients
The Health Care Authority of the City of Huntsville Past Accepting new patients

Locations

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

1 Hospital Dr SW
Huntsville, AL 35801
Phone (256) 429-4000

1301 S Cliff Ave
Ste 400
Sioux Falls, SD 57105
Phone (605) 322-5750

300 N Dakota Ave
Ste 117
Sioux Falls, SD 57104
Phone (605) 322-6800

Interoperability endpoints

  • Direct secure messaging: liesl.pavlic@avera.sdhealthlink.net

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1124287859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N DAKOTA AVE STE 117",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046020",
            "telephone_number": "605-322-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N DAKOTA AVE STE 117",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046020",
            "telephone_number": "605-322-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLIC",
        "first_name": "LIESL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "16948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.