Alyssa Jo Etzkorn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1218 Issued in SD

Practice address

100 Mac LN
Pierre, SD 57501-3391

Phone

(605) 945-5277

Fax

(605) 945-5389

NPI assigned

Sep 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera St Mary'S Hospital Hospital, Pierre, SD, CCN 430015
• Avera Hand County Memorial Hospital and Clinic Hospital, Miller, SD, CCN 431337

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alyssa.bump@avera.sdhealthlink.net

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.

• Avera St Marys

  • General Acute Care Hospital
  • Pierre, SD
  • NPI 1669457180
  Medicare reassignment Care Compare group NPD
• Rural Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Murdo, SD
  • NPI 1720076441
  Medicare reassignment
• Avera St Marys

  • Emergency Medicine Physician
  • Pierre, SD
  • NPI 1073305496
  NPD
• Rural Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Onida, SD
  • NPI 1992793616
  NPD
• Rural Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Marshall, MN
  • NPI 1740944602
  NPD

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

• Avera McKennan

  • Critical Access Hospital
  • Miller, SD
  • NPI 1922277060
  Care Compare affiliation
• Avera St Marys

  • General Acute Care Hospital
  • Pierre, SD
  • NPI 1669457180
  Care Compare affiliation
• Avera St Marys

  • Multi-Specialty Clinic/Center
  • Pierre, SD
  • NPI 1720326713

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1235780883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 VILLAGE DR",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575012886",
            "telephone_number": "605-222-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LN",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013391",
            "telephone_number": "605-945-5277",
            "fax_number": "605-945-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETZKORN",
        "first_name": "ALYSSA",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denette K. Eisnach, O.D.
• Jeff Ekle, MA LPC CAC
• Erick Rath DDS PHD PC
• Cindy D. Erwin, P.A.-C.
• Tara Espland, MS
• Danielle Elizabeth Etzkorn
• Matthew Alex Falk, AU.D.
• Deb Ann Farnsworth
• Cheryl Feiock, LPC-MH, QMHP
• Katherine Ferraro

• Physician Assistant in Pierre, SD
• Providers in Pierre, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.