NPIMap

Individual provider Active NPI

William W Devine, MD

  • Family Medicine Physician
  • Watertown, SD
National Provider Identifier
1376522854
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4393 Issued in SD
Practice address
901 4TH St NW
Watertown, SD 57201-1558
Phone
(605) 886-8471
Fax
(605) 886-9317
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4393 SD Primary

Addresses

Primary practice location

901 4TH St NW
Watertown, SD 57201-1558

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 312-7605

Other identifiers 1

IdentifierTypeStateIssuer
5610332MedicaidSD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wdevine3715@direct.sanfordhealth.org

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
I20040510000584 SD Practitioner - Family PracticePractitioner - General Practice 6608865324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 886-9317

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

901 4TH St NW
Watertown, SD 57201-1558
Phone (605) 886-8471

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4393SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic Family Medicine CurrentSince Jan 1, 1999 Accepting new patients
Sanford Clinic CurrentSince Jan 1, 1999 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Medical Center Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Prairie Lakes Health Care System Inc Past Accepting new patients
Lake Norden SD Skilled Nursing Facility LLC Past Accepting new patients

Locations

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

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

901 4th St NW
Watertown, SD 57201
Phone (605) 882-8780

1401 W 1st St
Webster, SD 57274
Phone (605) 345-3336

Interoperability endpoints

  • Direct secure messaging: wdevine3715@direct.sanfordhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avantara Lake NordenLake Norden, SD, CCN 435059 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2019
Jul 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 7

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1376522854",
    "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": "605-312-7605",
            "fax_number": "605-312-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 4TH ST NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011558",
            "telephone_number": "605-886-8471",
            "fax_number": "605-886-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5610332",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wdevine3715@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "901 4th St NW",
            "city": "Watertown",
            "state": "SD",
            "country_code": "US",
            "postal_code": "572011558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.