NPIMap

Individual provider Active NPI

Jonathan Caceres Olegario, M.D.

  • Internal Medicine Physician
  • Mitchell, SD
National Provider Identifier
1376532697
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5718 Issued in SD
Practice address
120 W 6TH Ave
Mitchell, SD 57301-1920
Phone
(605) 996-9141
Fax
(605) 996-9194
NPI assigned
Oct 19, 2005
Last updated
May 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5718 SD Primary

Addresses

Primary practice location

120 W 6TH Ave
Mitchell, SD 57301-1920

Mailing address

1408 Ridge Rd
Mitchell, SD 57301-2175
Phone (605) 996-8066

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
I20051008000078 SD Practitioner - Internal Medicine 6002831286 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians
Avera Queen of PeaceGroup PAC ID 9335050806, shared by 12 NPIs, 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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Oct 1, 2014 Accepting new patients
Avera Queen of Peace CurrentSince Oct 1, 2014 Accepting new patients
Rural Health Care, Inc. Current Accepting new patients
Rural Health Care, Inc CurrentSince Nov 1, 2019 Accepting new patients
Rural Health Care, Inc CurrentSince Nov 1, 2019 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Firesteel SNF Operations, LLC Past Accepting new patients

Locations

265 E Main St
Corsica, SD 57328
Phone (605) 946-5411

1900 Grassland Dr
Ste 103
Mitchell, SD 57301
Phone (605) 995-4900

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

Interoperability endpoints

  • Direct secure messaging: jonathan.olegario@avera.sdhealthlink.net

Organizations & group practices 9

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1376532697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 RIDGE RD",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012175",
            "telephone_number": "605-996-8066",
            "fax_number": "605-996-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W 6TH AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011920",
            "telephone_number": "605-996-9141",
            "fax_number": "605-996-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEGARIO",
        "first_name": "JONATHAN",
        "middle_name": "CACERES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "5718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.