NPIMap

Individual provider Active NPI

John Michael Travnicek, MD

  • Emergency Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1174556609
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5884 Issued in SD
Practice address
1325 S Cliff Ave
Emergency Dept
Sioux Falls, SD 57105-1007
Phone
(605) 322-2000
Fax
(605) 322-2036
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5884 SD Primary

Addresses

Primary practice location

1325 S Cliff Ave
Emergency Dept
Sioux Falls, SD 57105-1007

Mailing address

PO Box 5045
P.F.S.
Sioux Falls, SD 57117-5045
Phone (605) 322-2000

Other identifiers 7

IdentifierTypeStateIssuer
349C2TROtherSDMN BLUECROSS BS
477608000MedicaidMN
4993479OtherSDBLUE CROSS OF SD
5884OtherSDDAKOTACARE
46022474331MedicaidNE
1174556609MedicaidIA
6631370MedicaidSD

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
I20060927000393 SD Practitioner - Emergency Medicine 1759386626 Reassigns benefits to 1 organization
I20170519001278 TX Practitioner - Emergency Medicine 1759386626 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rosebud Indian Health Service CurrentSince Apr 8, 2017 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 8, 2017 Accepting new patients
Rosebud Indian Health Service CurrentSince Apr 8, 2017 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Avera McKennan CurrentSince Aug 1, 2006 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 8, 2017 Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Apr 8, 2017 Accepting new patients
Avera McKennan Current Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Apr 8, 2017 Accepting new patients
Winnebago Tribe of Nebraska Past Accepting new patients
Lisbon Area Health Services Past Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Interoperability endpoints

  • Direct secure messaging: john.travnicek.1@16187.direct.athenahealth.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1174556609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "address_2": "P.F.S.",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "605-322-2000",
            "fax_number": "605-322-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "address_2": "EMERGENCY DEPT",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-322-2000",
            "fax_number": "605-322-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVNICEK",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "5884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BLUECROSS BS",
            "identifier": "349C2TR",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "477608000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF SD",
            "identifier": "4993479",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "5884",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46022474331",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174556609",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6631370",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.