NPIMap

Individual provider Active NPI

John M Van Erdewyk, MD

  • Anesthesiology Physician
  • Mitchell, SD
National Provider Identifier
1154344711
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
3562 Issued in SD
Practice address
525 N Foster St
Mitchell, SD 57301-2966
Phone
(605) 995-2000
Fax
(605) 995-5645
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 3562 SD Primary

Addresses

Primary practice location

525 N Foster St
Mitchell, SD 57301-2966

Mailing address

PO Box 5126
Sioux Falls, SD 57117-5126
Phone (605) 335-1952

Other identifiers 3

IdentifierTypeStateIssuer
050019274OtherSDRAILROAD MEDICARE
5700590MedicaidSD
0002189OtherSDBCBS

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
I20100407000170 SD Practitioner - Anesthesiology 2769543727 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Sanford School of Medicine of University of South Dakota, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera Queen of PeaceGroup PAC ID 9335050806, 122 clinicians

Practice addresses (Care Compare)

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-2000

Hospital & facility affiliations

  • Avera Queen of Peace Hospital, Mitchell, SD, CCN 431340
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3562SDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services CurrentSince Sep 9, 2024 Accepting new patients
Mitchell Anesthesia PC Anesthesiology CurrentSince Aug 1, 1994 Accepting new patients
Sacred Heart Health Services CurrentSince Sep 9, 2024 Accepting new patients
Avera Queen of Peace CurrentSince Oct 1, 2023 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Avera Queen of Peace CurrentSince Oct 1, 2023 Accepting new patients
Watertown Anesthesia PC Anesthesiology PastSince Feb 2, 2020 Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1154344711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5126",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175126",
            "telephone_number": "605-335-1952",
            "fax_number": "605-373-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N FOSTER ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012966",
            "telephone_number": "605-995-2000",
            "fax_number": "605-995-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ERDEWYK",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SD",
            "license": "3562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050019274",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5700590",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0002189",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.