NPIMap

Individual provider Active NPI

Clayton Gerald Vanbalen, MD

  • Occupational Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1316943251
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
2540 Issued in SD
Practice address
900 E 54TH St N
Sioux Falls, SD 57104
Phone
(605) 338-9300
Fax
(605) 338-9301
NPI assigned
Jun 24, 2005
Last updated
Mar 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2540 SD
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 2540 SD
Occupational Medicine Physician 2083X0100X 2540 SD Primary

Addresses

Primary practice location

900 E 54TH St N
Sioux Falls, SD 57104

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other identifiers 1

IdentifierTypeStateIssuer
5602923MedicaidSD

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
I20041101000769 SD Practitioner - Preventive MedicinePractitioner - Other (Physician)Practitioner - Family Practice 0345210753 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Sanford School of Medicine of University of South Dakota, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 224-5901

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2540SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince May 16, 2023 Accepting new patients
Avera St Marys CurrentSince Dec 1, 2022 Accepting new patients
Avera McKennan CurrentSince May 16, 2023 Accepting new patients
Sanford Medical Center Family Medicine CurrentSince Aug 9, 2012 Accepting new patients
Sanford Clinic CurrentSince Oct 10, 2004 Accepting new patients
Sanford Clinic CurrentSince Oct 10, 2004 Accepting new patients
Sanford Clinic Current Accepting new patients
Avera St Marys CurrentSince Dec 1, 2022 Accepting new patients
Avera McKennan Current Accepting new patients
Sanford Medical Center CurrentSince Aug 9, 2012 Accepting new patients
Mercy Medical Services Family Medicine Past Accepting new patients
Avera McKennan Family Medicine Past Accepting new patients

Locations

1101 9th St SE
Sioux Center, IA 51250
Phone (712) 722-1271

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

1500 W 22nd St
Ste 102
Sioux Falls, SD 57105
Phone (605) 328-8800

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

900 E 54th St N
Ste 200
Sioux Falls, SD 57104
Phone (605) 328-9300

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Interoperability endpoints

  • Direct secure messaging: clayton.vanbalen@avera.sdhealthlink.net

Organizations & group practices 12

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 2

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1316943251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 54TH ST N",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57104",
            "telephone_number": "605-338-9300",
            "fax_number": "605-338-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBALEN",
        "first_name": "CLAYTON",
        "middle_name": "GERALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "2540",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "SD",
            "license": "2540",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "SD",
            "license": "2540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5602923",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.