NPIMap

Individual provider Active NPI

Mikayla Lynn Heronimus, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1205460862
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
111257 Issued in IA
Practice address
1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone
(605) 312-2200
NPI assigned
Feb 23, 2020
Last updated
May 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1429 SD
Physician Assistant 363A00000X 111257 IA Primary

Addresses

Primary practice location

1301 W 18TH St
Sioux Falls, SD 57105-0401

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD, MN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220308000953 IA Practitioner - Physician Assistant 1951795970 Reassigns benefits to 2 organizations
I20230608003181 SD Practitioner - Physician Assistant 1951795970 Reassigns benefits to 2 organizations
I20230816000086 MN Practitioner - Physician Assistant 1951795970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
75.87
Promoting interoperability
100
Improvement activities
40
Cost
68.53

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111257IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince May 1, 2023 Accepting new patients
Sanford Medical Center Physician Assistant CurrentSince May 1, 2023 Accepting new patients
Sanford Clinic Physician Assistant CurrentSince Jul 2, 2023 Accepting new patients
Sanford Clinic CurrentSince May 1, 2023 Accepting new patients
Sanford Medical Center CurrentSince May 1, 2023 Accepting new patients
Sanford Clinic CurrentSince May 1, 2023 Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

303 E Jefferson St
Inwood, IA 51240
Phone (712) 753-4401

104 Buncombe Dr
Rock Rapids, IA 51246
Phone (712) 472-3333

118 N 7th Ave
Sheldon, IA 51201
Phone (712) 324-5041

1601 Sioux Valley Dr
Luverne, MN 56156
Phone (507) 283-4476

922 22nd Ave S
Brookings, SD 57006
Phone (605) 697-1900

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

521 E Sioux Ave
Pierre, SD 57501
Phone (605) 224-2010

1301 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-2100

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

901 4th St NW
Watertown, SD 57201
Phone (605) 882-8780

Organizations & group practices 9

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.

Hospital & facility affiliations 8

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": "1582416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1205460862",
    "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": "605-328-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-312-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERONIMUS",
        "first_name": "MIKAYLA",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-23",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1429",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "111257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.