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Organization Active NPI

Sanford Clinic

Doing business as Sanford Clinic Breast Health Institute

  • Radiation Oncology Physician
  • Sioux Falls, SD
National Provider Identifier
1174537799
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
SANFORD CLINIC
Doing business as
Sanford Clinic Breast Health Institute
Sanford Health Edith Sanford Breast Center Outreach
Sanford Health Edith Sanford Breast Center Watertown
Practice address
1309 W 17TH St Ste G01
Sioux Falls, SD 57104-4664
Phone
(605) 312-3400
Fax
(605) 312-3401
NPI assigned
Jul 28, 2006
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

1309 W 17TH St Ste G01
Sioux Falls, SD 57104-4664

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

901 4th St NW
Watertown, SD 57201-1558
Phone (605) 886-1587

Other identifiers 2

IdentifierTypeStateIssuer
0592709MedicaidIA
043900200MedicaidMN

Other names 3

  • Sanford Clinic Breast Health Institute Doing business as
  • Sanford Health Edith Sanford Breast Center Outreach Doing business as
  • Sanford Health Edith Sanford Breast Center Watertown Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Sanford Clinic33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

  • Sanford Clinic

    dba Sanford 69th & Louise Family Medicine

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1104255835
    NPD tax ID
  • Sanford Clinic

    dba Sanford Health Lake Lorraine Eye Clinic

    • Clinic/Center
    • Sioux Falls, SD
    • NPI 1164069506
    NPD tax ID
  • Sanford Clinic

    dba Sanford Medical Genetics Laboratory

    • Clinical Medical Laboratory
    • Sioux Falls, SD
    • NPI 1346410115
    NPD tax ID
  • Sanford Clinic

    dba Sanford Acute Care 69th & Minnesota Clinic

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1366450835
    NPD tax ID
  • Sanford Clinic

    dba Sanford Children's 69th & Louise Clinic

    • Pediatrics Physician
    • Sioux Falls, SD
    • NPI 1386072569
    NPD tax ID
  • Sanford Clinic

    dba Sanford Gynecologic Oncology Clinic

    • Gynecologic Oncology Physician
    • Sioux Falls, SD
    • NPI 1396089900
    NPD tax ID
  • Sanford Clinic

    dba Sanford Children's Residency Clinic

    • Pediatrics Physician
    • Sioux Falls, SD
    • NPI 1437438306
    NPD tax ID
  • Sanford Clinic

    dba Sanford 26th and Sycamore Family Medicine

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1447289343
    NPD tax ID
  • Sanford Clinic

    dba Edith Sanford Breast Specialty Clinic

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1497163026
    NPD tax ID
  • Sanford Clinic

    dba Sanford Health Lake Lorraine Eye Clinic

    • Eyewear Supplier
    • Sioux Falls, SD
    • NPI 1518599562
    NPD tax ID
  • Sanford Clinic

    dba Sanford Clinic Gastroenterology

    • Gastroenterology Physician
    • Sioux Falls, SD
    • NPI 1518973221
    NPD tax ID
  • Sanford Clinic

    dba Sanford Diabetes and Thyroid Clinic

    • Endocrinology, Diabetes & Metabolism Physician
    • Sioux Falls, SD
    • NPI 1578589677
    NPD tax ID
View all 32

Locations

1500 W 22nd St
Ste 302
Sioux Falls, SD 57105
Phone (605) 328-8888

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1174537799",
    "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",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 W 17TH ST STE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044664",
            "telephone_number": "605-312-3400",
            "fax_number": "605-312-3401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 4th St NW",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "SD",
            "postal_code": "572011558",
            "country_code": "US",
            "telephone_number": "605-886-1587",
            "fax_number": "605-882-8626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANFORD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0592709",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043900200",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sanford Clinic Breast Health Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Health Edith Sanford Breast Center Outreach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Health Edith Sanford Breast Center Outreach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sanford Health Edith Sanford Breast Center Watertown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.