Active NPI
Dylan Stahly
- Physician Assistant
- Sioux Falls, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1210 W 18TH St Ste 100
Sioux Falls, SD 57104-4650 - Phone
- (605) 312-8500
- NPI assigned
- Apr 21, 2022
- Last updated
- Jan 24, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary | |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
1210 W 18TH St Ste 100
Sioux Falls, SD 57104-4650
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center | Physician Assistant | Current | Accepting new patients |
| Sanford Medical Center | Current | Accepting new patients |
Locations
1210 W 18th St
Ste 100
Sioux Falls, SD 57104
Phone (605) 312-8500
4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Family Medicine Physician
- Sioux Falls, SD
- NPI 1093090342
Physician Assistant
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dba Sanford Clinic Lake Norden
- Rural Health Clinic/Center
- Lake Norden, SD
- NPI 1417927559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706054400000",
"number": "1174267587",
"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": "1210 W 18TH ST STE 100",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571044650",
"telephone_number": "605-312-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAHLY",
"first_name": "DYLAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-21",
"last_updated": "2024-01-24",
"certification_date": "2024-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.