Individual provider Active NPI

David Evan Mendel, LCSW

  • Clinical Social Worker
  • Watertown, SD
National Provider Identifier
1174750343
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3038 Issued in SD
Practice address
123 19TH St NE
Watertown, SD 57201-2823
Phone
(605) 886-0123
Fax
(605) 886-5447
NPI assigned
Jun 16, 2009
Last updated
Oct 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3038 SD Primary

Addresses

Primary practice location

123 19TH St NE
Watertown, SD 57201-2823

Mailing address

PO Box 1030
Watertown, SD 57201-6030
Phone (605) 886-0123

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090827000158 SD Practitioner - Clinical Social Worker 3971658998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Human Service AgencyGroup PAC ID 3375447394, 8 clinicians

Practice addresses (Care Compare)

123 19TH St NE
Watertown, SD 57201-2823
Phone (605) 886-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3038SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Human Service Agency CurrentSince Oct 7, 2016 Accepting new patients

Locations

123 19th St NE
Watertown, SD 57201
Phone (605) 884-3512

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1174750343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016030",
            "telephone_number": "605-886-0123",
            "fax_number": "605-886-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 19TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572012823",
            "telephone_number": "605-886-0123",
            "fax_number": "605-886-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEL",
        "first_name": "DAVID",
        "middle_name": "EVAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "3038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.