NPIMap

Individual provider Active NPI

Amjad Panickaveettil Mohamed Basheer, MBBS

  • Cardiovascular Disease Physician
  • Sioux Falls, SD
National Provider Identifier
1255994901
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
17325 Issued in SD
Practice address
4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone
(605) 977-5000
Fax
(605) 977-5377
NPI assigned
Apr 18, 2019
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 17325 SD Primary

Addresses

Primary practice location

4520 W 69TH St
Sioux Falls, SD 57108-8148

Mailing address

Uconn Graduate Medical Education
263 Farmington Avenue Lm068
Farmington, CT 06030-1921
Phone (860) 879-4763

Other practice location 1

UConn Health - General Medicine Clinic
263 Farmington Ave, OP 2 East
Farmington, CT 06030-8021
Phone (860) 679-4477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MN, SD3 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
I20250805002458 IA Practitioner - Cardiovascular Disease (Cardiology) 4385975408 Reassigns benefits to 2 organizations
I20250813001151 MN Practitioner - Cardiovascular Disease (Cardiology) 4385975408 Reassigns benefits to 1 organization
I20250815003031 SD Practitioner - Cardiovascular Disease (Cardiology) 4385975408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 537-9007

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

926 N 8TH St
NCH Avera Medical Group Esthervill
Estherville, IA 51334-1300
Phone (712) 362-6501

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17325SDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 14, 2025 Accepting new patients
Avera McKennan Current Accepting new patients
Heart Hospital of South Dakota LLC Cardiovascular Disease CurrentSince Jul 21, 2025 Accepting new patients
Avera McKennan CurrentSince Jul 14, 2025 Accepting new patients
Heart Hospital of South Dakota LLC Past Accepting new patients

Locations

926 N 8th St
Estherville, IA 51334
Phone (712) 362-3501

1100 S 10th Ave
Rock Rapids, IA 51246
Phone (712) 348-0617

116 E 11th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

4520 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-5000

Interoperability endpoints

  • Direct secure messaging: amjad.basheer@avera.sdhealthlink.net

Organizations & group practices 5

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1255994901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCONN GRADUATE MEDICAL EDUCATION",
            "address_2": "263 FARMINGTON AVENUE LM068",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301921",
            "telephone_number": "860-879-4763",
            "fax_number": "860-879-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UConn Health - General Medicine Clinic",
            "address_2": "263 Farmington Ave, OP 2 East",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060308021",
            "country_code": "US",
            "telephone_number": "860-679-4477",
            "fax_number": "860-679-1025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANICKAVEETTIL MOHAMED BASHEER",
        "first_name": "AMJAD",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SD",
            "license": "17325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.