NPIMap

Individual provider Active NPI

Racheal Tushabe, MD

  • Internal Medicine Physician
  • Aberdeen, SD
National Provider Identifier
1255767273
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2022-00159 Issued in NC
Practice address
815 1St Ave SE Ste 104
Aberdeen, SD 57401
Phone
(605) 622-5458
Fax
(605) 622-5473
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57927 MN
Internal Medicine Physician 207R00000X 2022-00159 NC Primary
Internal Medicine Physician 207R00000X 10667 SD

Addresses

Primary practice location

815 1St Ave SE Ste 104
Aberdeen, SD 57401

Mailing address

PO Box 110566
Durham, NC 27709-5566
Phone (919) 620-4855

Other practice location 1

1216 Ryans Rd
Worthington, MN 56187-1722
Phone (507) 372-2921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180814001774 SD Practitioner - Internal Medicine 0749401370 Reassigns benefits to 1 organization
I20220712002239 NC Practitioner - Internal Medicine 0749401370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

201 Sage Rd
Chapel Hill, NC 27514-6510
Phone (919) 385-2000

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10667SDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Internal Medicine Current Accepting new patients
Avera St. Lukes CurrentSince Jul 23, 2018 Accepting new patients
Avera St. Luke'S Internal Medicine Current Accepting new patients
Duke University Affliated Physicians CurrentSince Jul 11, 2022 Accepting new patients
Duke University Affiliated Physicians, Inc. Internal Medicine CurrentSince Jul 11, 2022 Accepting new patients
Avera St. Luke'S CurrentSince Jul 23, 2018 Accepting new patients

Locations

300 S Bruce St
Ste 100
Marshall, MN 56258

201 Sage Rd
Chapel Hill, NC 27514
Phone (802) 522-6077

201 Sage Rd
Ste 300
Chapel Hill, NC 27514
Phone (919) 385-2030

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

815 1st Ave SE
Ste 104
Aberdeen, SD 57401
Phone (605) 225-0378

Interoperability endpoints

  • Direct secure messaging: rtushabe518432@direct.medicine.duke.edu
  • Direct secure messaging: racheal.tushabe.1@15839.direct.athenahealth.com
  • Direct secure messaging: racheal.tushabe@avera.sdhealthlink.net

Organizations & group practices 6

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 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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1255767273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110566",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277095566",
            "telephone_number": "919-620-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 1ST AVE SE STE 104",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "57401",
            "telephone_number": "605-622-5458",
            "fax_number": "605-622-5473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1216 Ryans Rd",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "MN",
            "postal_code": "561871722",
            "country_code": "US",
            "telephone_number": "507-372-2921",
            "fax_number": "507-372-5789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUSHABE",
        "first_name": "RACHEAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "57927",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2022-00159",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "10667",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.