Active NPI
Ray T Birkenkamp, M.D.
- Ophthalmology Physician
- Mitchell, SD
National Provider Identifier
1174594741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- S2475
- Practice address
- 305 N Sanborn Blvd
Mitchell, SD 57301-2449 - Phone
- (605) 996-2537
- Fax
- (605) 996-0500
- NPI assigned
- Jan 31, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | S2475 | SD | Primary |
Addresses
Primary practice location
305 N Sanborn Blvd
Mitchell, SD 57301-2449
Mailing address
305 N Sanborn Blvd
Mitchell, SD 57301-2449
Phone (605) 996-2537
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6300290 | Medicaid | SD | |
| 25172 | Other | SD | SANFORD HEALTH PLAN |
| 0009375 | Other | SD | WELLMARK BCBS |
| 2475 | Other | SD | DAKOTACARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S2475 | SD | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1174594741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 N SANBORN BLVD",
"city": "MITCHELL",
"state": "SD",
"postal_code": "573012449",
"telephone_number": "605-996-2537",
"fax_number": "605-996-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 N SANBORN BLVD",
"city": "MITCHELL",
"state": "SD",
"postal_code": "573012449",
"telephone_number": "605-996-2537",
"fax_number": "605-996-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRKENKAMP",
"first_name": "RAY",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SD",
"license": "S2475",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6300290",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SANFORD HEALTH PLAN",
"identifier": "25172",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "0009375",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAKOTACARE",
"identifier": "2475",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mitchell, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.