Individual provider Active NPI

Sergio George Plucker-Billups

  • Student in an Organized Health Care Education/Training Program
  • Sioux Falls, SD
National Provider Identifier
1275060865
Registry record updated May 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1400 W 22ND St
Sioux Falls, SD 57105-1554
Phone
(605) 322-5737
NPI assigned
May 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1400 W 22ND St
Sioux Falls, SD 57105-1554

Mailing address

613 E 20TH St
Sioux Falls, SD 57105-0920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190326001782 IA Practitioner - Psychiatry 6608148044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer Municipal HospitalGroup PAC ID 4183533060, 95 clinicians

Practice addresses (Care Compare)

1200 1St Ave E
Spencer, IA 51301-4330

1200 1St Ave E
Spencer, IA 51301-4342
Phone (712) 264-6198

1200 1St Ave E C
Nwia Bone Joint and Sports Surgeons
Spencer, IA 51301-4342
Phone (712) 262-7511

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital CurrentSince Jun 9, 2019 Accepting new patients
Spencer Municipal Hospital CurrentSince Jun 9, 2019 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital Past Accepting new patients
Northwest Iowa Dermatology LLC Past Accepting new patients

Locations

101 E 10th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

1200 1st Ave E
Ste 1
Spencer, IA 51301
Phone (712) 264-6160

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 5

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": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494806400000",
    "number": "1275060865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 E 20TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051554",
            "telephone_number": "605-322-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUCKER-BILLUPS",
        "first_name": "SERGIO",
        "middle_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2017-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.