Individual provider Active NPI

Theresa Oey-Trudeau, MD

  • Surgery Physician
  • Brookings, SD
National Provider Identifier
1285839787
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
8556 Issued in SD
Practice address
400 22ND Ave
Brookings, SD 57006-2497
Phone
(605) 697-9500
Fax
(605) 697-6939
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 8556 SD Primary

Addresses

Primary practice location

400 22ND Ave
Brookings, SD 57006-2497

Mailing address

310 22ND Ave
Brookings, SD 57006-2474
Phone (605) 696-2700

Other identifiers 1

IdentifierTypeStateIssuer
8556OtherSDSTATE LICENSE

Other names 1

  • Theresa Dale Hong Gwat Oey-Devine Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20120928000653 SD Practitioner - General Surgery 7517116940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Sanford School of Medicine of University of South Dakota, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of BrookingsGroup PAC ID 1052307105, 112 clinicians

Practice addresses (Care Compare)

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 692-6351

300 22ND Ave
Brookings, SD 57006-2496

310 22ND Ave
Brookings, SD 57006-2474
Phone (605) 697-9500

Hospital & facility affiliations

  • Brookings Health System Hospital, Brookings, SD, CCN 430008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy68
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux73
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Brookings CurrentSince Jan 1, 2014 Accepting new patients
Avera McKennan CurrentSince Aug 4, 2012 Accepting new patients
City of Brookings Current Accepting new patients
City of Brookings CurrentSince Jan 1, 2014 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Aug 4, 2012 Accepting new patients

Locations

310 22nd Ave
Brookings, SD 57006
Phone (605) 696-2700

400 22nd Ave
Brookings, SD 57006
Phone (605) 692-6236

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

Interoperability endpoints

  • Direct secure messaging: theresa.oeytrudeau@avera.sdhealthlink.net

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 4

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1285839787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062474",
            "telephone_number": "605-696-2700",
            "fax_number": "605-697-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062497",
            "telephone_number": "605-697-9500",
            "fax_number": "605-697-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OEY-TRUDEAU",
        "first_name": "THERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "8556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "8556",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "OEY-DEVINE",
            "middle_name": "DALE HONG GWAT",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookings, SD

Sources for this page

Verify at the official NPI Registry.