Ryan Mark Sivertson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

9573 Issued in SD

Practice address

1305 W 18TH St
Sioux Falls, SD 57105-0401

Phone

(605) 333-1000

Fax

(605) 328-4560

NPI assigned

Jun 8, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

84.78 of 100Reported as group

Quality

78.77

Promoting interoperability

100

Improvement activities

40

Cost

70.49

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sanford Medical Center

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342
  Medicare reassignment NPD

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1205198082",
    "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": "605-333-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-333-1000",
            "fax_number": "605-328-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVERTSON",
        "first_name": "RYAN",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301101181",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301101181",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "9573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Sisson
• Derek J Sitter, PAC
• Thabuna Sivaprakasam, MD
• Leanne S Siverhus, CRNA
• Andy Sivertson
• John Wesley Joseph Sivesind, O.D.
• Sivesind, Tims & Clarke, Prof. L.L.C.
• Sizewise Rentals LLC
• Kelsey Sjaarda, CSW-PIP
• Shelby Sjaarda

• Emergency Medicine Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Emergency Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.