NPIMap

Individual provider Active NPI

Fares Yousef Masannat, MD

  • Infectious Disease Physician
  • Sioux Falls, SD
National Provider Identifier
1144425323
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
7518 Issued in SD
Practice address
6709 S Minnesota Ave
Suite 102
Sioux Falls, SD 57108-2592
Phone
(605) 335-1952
Fax
(605) 373-9971
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PG PERMIT # 76497 AZ
Infectious Disease Physician 207RI0200X 7518 SD Primary

Addresses

Primary practice location

6709 S Minnesota Ave
Suite 102
Sioux Falls, SD 57108-2592

Mailing address

6709 S Minnesota Ave Ste 102
Sioux Falls, SD 57108-2593
Phone (605) 322-7250

Other identifiers 2

IdentifierTypeStateIssuer
RAILROAD MEDICAREOtherSDP00751793
6632250MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090811000392 SD Practitioner - Infectious Disease 2961556931 Reassigns benefits to 1 organization
I20180220001635 TX Practitioner - Internal MedicinePractitioner - Infectious Disease 2961556931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Michael'S Hospital, Inc.Group PAC ID 2668380262, shared by 6 NPIs, 16 clinicians
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

410 W 16TH Ave
Tyndall, SD 57066-2318
Phone (605) 589-2158

6709 S Minnesota Ave
Suite 102
Sioux Falls, SD 57108-2593
Phone (605) 322-7250

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PG PERMIT # 76497AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 1, 2017 Accepting new patients
Rosebud Indian Health Service CurrentSince Mar 3, 2018 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Sep 1, 2017 Accepting new patients
Rosebud Indian Health Service CurrentSince Mar 3, 2018 Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Feb 17, 2018 Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

6709 S Minnesota Ave
Ste 102
Sioux Falls, SD 57108
Phone (605) 322-7250

Interoperability endpoints

  • Direct secure messaging: fares.masannat@avera.sdhealthlink.net

Organizations & group practices 6

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.

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1144425323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6709 S MINNESOTA AVE STE 102",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082593",
            "telephone_number": "605-322-7250",
            "fax_number": "605-331-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6709 S MINNESOTA AVE",
            "address_2": "SUITE 102",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082592",
            "telephone_number": "605-335-1952",
            "fax_number": "605-373-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASANNAT",
        "first_name": "FARES",
        "middle_name": "YOUSEF",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "PG PERMIT # 76497",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SD",
            "license": "7518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P00751793",
            "identifier": "RAILROAD MEDICARE",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6632250",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.