Individual provider Active NPI

Kevin Daniel Vaughn, PA-C

  • Physician Assistant
  • Aberdeen, SD
National Provider Identifier
1194760215
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0236 Issued in SD
Practice address
3015 3Rd Ave SE
Aberdeen, SD 57401-5418
Phone
(605) 226-5500
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0236 SD
Physician Assistant 363A00000X 0236 SD Primary

Addresses

Primary practice location

3015 3Rd Ave SE
Aberdeen, SD 57401-5418

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230120002376 SD Practitioner - Physician Assistant 1951548437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Health Care IncGroup PAC ID 8921997933, 55 clinicians

Practice addresses (Care Compare)

106 S Main
Plankinton, SD 57368-0250
Phone (605) 942-7711

215 S Dumont
Woonsocket, SD 57385-0368
Phone (605) 796-4433

506 S Wilson St
Aberdeen, SD 57401-5082
Phone (605) 725-3900

602 1St St NE
Suite 1
Wessington Springs, SD 57382-2163
Phone (605) 539-1778

Hospital & facility affiliations

  • Avera Weskota Memorial Medical Center - Cah Hospital, Wessington Springs, SD, CCN 431324

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
80.98
Promoting interoperability
100
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0236SDMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince Nov 7, 2022 Accepting new patients
Horizon Health Care Inc CurrentSince May 28, 2025 Accepting new patients
Horizon Health Care Inc CurrentSince May 28, 2025 Accepting new patients
Sanford Health Network CurrentSince Nov 7, 2022 Accepting new patients
Horizon Health Care Inc Past Accepting new patients

Locations

506 S Wilson St
Aberdeen, SD 57401
Phone (605) 725-3900

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

1000 18th St SW
Ste 27
Huron, SD 57350
Phone (605) 554-1015

110 5th Ave
Ipswich, SD 57451
Phone (605) 426-4072

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

602 1st St NE
Ste 1
Wessington Springs, SD 57382
Phone (605) 539-1778

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1194760215",
    "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": "3015 3RD AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574015418",
            "telephone_number": "605-226-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "KEVIN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": "0236",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.