Sanford Clinic
Organization Active NPI Surgery Physician · Sioux Falls, SD
NPI 1164510608 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1164510608
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- SANFORD CLINIC
- Practice address
- 1201 S Euclid Ave Ste 201
Suite 201
Sioux Falls, SD 57105-0434 - Phone
- (605) 328-8100
- Fax
- (605) 328-8101
- NPI assigned
- Oct 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Steve Goetsch
- Title
- Cfo
- Phone
- (605) 328-6940
Other NPIs on the same Medicare enrollment 24
Practitioners 4
-
Donna Dickey, CNP
-
Jody N. Huber, M.D.
-
Nathan James Pfeifle, CNP
-
Susan Wicks, CSW-PIP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD, IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000532 | SD | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 941 practitioners This NPI is an additional NPI on the enrollment |
| O20040216001158 | IA | Part B Supplier - Clinic/Group Practice | 0244143824 |
Receives reassigned benefits from 66 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sheldon, IA; Sioux City, IA; Rock Rapids, IA; Orange City, IA; Inwood, IA; Hawarden, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician |
207RN0300X | |||
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
1201 S Euclid Ave Ste 201
Suite 201
Sioux Falls, SD 57105-0434
Mailing address
1201 S Euclid Ave Ste 201
Suite 201
Sioux Falls, SD 57105-0434
Phone (605) 328-8100
Other names
- Sanford Clinic Transplant Nephrology
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other |
Other providers in Sioux Falls, SD
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
- Sanford Clinic
All providers in Sioux Falls, SD · Surgery Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.