NPIMap

Individual provider Active NPI

Kelsey Marie Bender, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Mitchell, SD
National Provider Identifier
1356070577
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1483 Issued in SD
Practice address
1900 Grassland Dr
Mitchell, SD 57301-6335
Phone
(605) 995-7000
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1483 SD Primary

Addresses

Primary practice location

1900 Grassland Dr
Mitchell, SD 57301-6335

Mailing address

1900 Grassland Dr
Mitchell, SD 57301-6335
Phone (605) 995-7000

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
I20231128003605 SD Practitioner - Physician Assistant 3678921848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care Inc 156 clinicians
Avera Queen of Peace 122 clinicians

Practice addresses (Care Compare)

1900 Grassland Dr
Suite 103
Mitchell, SD 57301-6386
Phone (605) 995-7000

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-2234

609 Garfield Ave
Murdo, SD 57559-4100
Phone (605) 669-2121

Hospital & facility affiliations

  • Avera Queen of Peace Hospital, Mitchell, SD, CCN 431340
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1483SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace CurrentSince Nov 12, 2023 Accepting new patients
Rural Health Care, Inc. CurrentSince Nov 12, 2023 Accepting new patients
Avera Queen of Peace CurrentSince Nov 12, 2023 Accepting new patients
Rural Health Care, Inc CurrentSince Nov 12, 2023 Accepting new patients

Locations

1900 Grassland Dr
Mitchell, SD 57301
Phone (605) 655-1220

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

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1356070577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GRASSLAND DR",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573016335",
            "telephone_number": "605-995-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GRASSLAND DR",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573016335",
            "telephone_number": "605-995-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.