Individual provider Active NPI

Kaitlyn Marie Villarreal, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1124844352
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2400 W 49TH St
Sioux Falls, SD 57105-6581
Phone
(605) 312-8700
NPI assigned
Dec 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X SD Primary

Addresses

Primary practice location

2400 W 49TH St
Sioux Falls, SD 57105-6581

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

5300 S Marion Rd Apt 410
Sioux Falls, SD 57106-6718
Phone (605) 270-6265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251113003003 SD Practitioner - Physician Assistant 3870084288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1585SDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Physician Assistant CurrentSince Oct 13, 2025 Accepting new patients

Locations

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

2400 W 49th St
Sioux Falls, SD 57105
Phone (605) 312-8700

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

Organizations & group practices 1

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": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1124844352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W 49TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056581",
            "telephone_number": "605-312-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 S Marion Rd Apt 410",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571066718",
            "country_code": "US",
            "telephone_number": "605-270-6265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.