NPIMap

Individual provider Active NPI

Jason Knudson, MD

  • Family Medicine Physician
  • Spearfish, SD
National Provider Identifier
1265405864
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5441 Issued in SD
Practice address
1420 N 10TH St
Spearfish, SD 57783
Phone
(605) 642-8414
Fax
(605) 642-8618
NPI assigned
Feb 13, 2006
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5441 SD Primary

Addresses

Primary practice location

1420 N 10TH St
Spearfish, SD 57783

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Other identifiers 1

IdentifierTypeStateIssuer
5611080MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040809000120 SD Practitioner - Family Practice 8729050034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, 163 clinicians

Practice addresses (Care Compare)

1420 N 10TH St
Spearfish, SD 57783-1532
Phone (605) 717-8595

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5441SDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. CurrentSince Nov 29, 2009 Accepting new patients
Monument Health Network, Inc. Family Medicine CurrentSince Nov 29, 2009 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1420 N 10th St
Spearfish, SD 57783
Phone (605) 642-8414

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536

Interoperability endpoints

  • Direct secure messaging: jknudson.8540@regionalhealth.sdhealthlink.net

Ownership & related parties

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Monument Health Lead-Deadwood HospitalDeadwood, SD, CCN 431320 Hospital Corporate Director Jul 1, 2021
Monument Health Sturgis HospitalSturgis, SD, CCN 431321 Hospital Corporate Director Jul 1, 2021
Monument Health Custer HospitalCuster, SD, CCN 431323 Hospital Corporate Director Jul 1, 2021
Monument Health Lead-Deadwood HospitalDeadwood, SD, CCN 43Z320 Hospital Corporate Director Jul 1, 2021
Monument Health Custer HospitalCuster, SD, CCN 43Z323 Hospital Corporate Director Jul 1, 2021
Monument Health Spearfish HospitalSpearfish, SD, CCN 430048 Hospital Corporate Director Jul 1, 2021
Monument Health Sturgis HospitalSturgis, SD, CCN 43Z321 Hospital Corporate Director Jul 1, 2021
Monument Health Care CenterSturgis, SD, CCN 435102 Skilled nursing facility Corporate Director Jul 1, 2021
Monument Health Hill City ClinicHill City, SD, CCN 433437 Rural health clinic Corporate Director Jul 1, 2021
Monument Health Belle Fourche ClinicBelle Fourche, SD, CCN 433440 Rural health clinic Corporate Director Jul 1, 2021
Monument Health Hot Springs ClinicHot Springs, SD, CCN 433890 Rural health clinic Corporate Director Jul 1, 2021

Owned or controlled facilities with NPI records 21

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 21

Organizations & group practices 4

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1265405864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N 10TH ST",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "57783",
            "telephone_number": "605-642-8414",
            "fax_number": "605-642-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "5441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5611080",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

Verify at the official NPI Registry.