Jacek Bednarz Jr., DO
Individual provider Active NPI Family Medicine Physician · Aberdeen, SD
NPI 1255911145 · NPPES record last updated Jul 19, 2024
Key facts
- NPI
- 1255911145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 15558 (SD)
- Practice address
- 105 S State St Ste 113
Aberdeen, SD 57401-4502 - Phone
- (605) 225-0378
- NPI assigned
- Apr 13, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Avera St Lukes
Practice addresses (Care Compare)
105 S State St
Aberdeen, SD 57401-4502
8 E US Hwy 12
Groton, SD 57445-2176
Phone (605) 397-4242
Hospital & facility affiliations
- Avera @ Home
- Avera @ Home
- Avera St Lukes
- Marshall County Healthcare Center - Cah
- Prairie Heights Healthcare
- Bethesda Home of Aberdeen
- Aberdeen Health and Rehab
- Avera Mother Joseph Manor Retirement Community
- Avantara Groton
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 20 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241003003855 | SD | Practitioner - Family Practice | 4385045475 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15558 | SD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera St. Luke'S | Current | Accepting new patients | |
| Avera St. Luke'S | Current |
Accepting new patients | |
| Avera St. Lukes | Current |
Accepting new patients |
Locations
105 S State St
Ste 113
Aberdeen, SD 57401
Phone (605) 225-0378
Interoperability endpoints
- jacek.bednarz@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15558 | SD | Yes |
Addresses
Primary practice location
105 S State St Ste 113
Aberdeen, SD 57401-4502
Mailing address
105 S State St Ste 113
Aberdeen, SD 57401-4502
Phone (605) 225-0378
Other providers in Aberdeen, SD
- Richard James Bartl
- Trista Bates
- Steven V Beare
- Tammi Adair Beck
- Debbie R Beckler
- Rachel Bekkerus
- Mikayla Bellefeuille
- Lea Ann Bender
- Leah Catherine Bennett
- Vicki Bent
All providers in Aberdeen, SD · Family Medicine Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.