NPIMap

Organization Active NPI

Pax PLLC

  • Multi-Specialty Clinic/Center
  • Sioux Falls, SD
National Provider Identifier
1275353237
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PAX PLLC
Practice address
6709 S Minnesota Ave Ste 101
Sioux Falls, SD 57108-2593
Phone
(605) 366-6569
NPI assigned
Oct 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Andrew Mortenson, MDNPI 1811230287
Title
Medical Director
Phone
(605) 366-6569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

6709 S Minnesota Ave Ste 101
Sioux Falls, SD 57108-2593

Mailing address

601 S Cliff Ave Ste 101
Sioux Falls, SD 57104-5276
Phone (605) 339-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250123003541 SD Part B Supplier - Clinic/Group Practice 0840729687 Receives reassigned benefits from 4 practitioners
Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory

Locations

601 S Cliff Ave
Ste 101
Sioux Falls, SD 57104

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1275353237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S CLIFF AVE STE 101",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571045276",
            "telephone_number": "605-339-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6709 S MINNESOTA AVE STE 101",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082593",
            "telephone_number": "605-366-6569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "MORTENSON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "605-366-6569",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.