Individual provider Active NPI

Jacob Lyngaas, MPA, PA-C

  • Physician Assistant
  • Huron, SD
National Provider Identifier
1376929000
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0988 Issued in SD
Practice address
172 4TH St SE
Huron, SD 57350-2510
Phone
(605) 353-6200
NPI assigned
Aug 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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 0988 SD Primary

Addresses

Primary practice location

172 4TH St SE
Huron, SD 57350-2510

Mailing address

PO Box 510
Britton, SD 57430-0510
Phone (605) 470-0559

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160222001715 SD Practitioner - Physician Assistant 1153626676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.59 of 100Reported as group
Quality
100
Promoting interoperability
96
Improvement activities
40
Cost
85.3

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Huron Regional Medical Center Inc CurrentSince Sep 8, 2015 Accepting new patients
Prairie Lakes Health Care System Inc Physician Assistant CurrentSince Mar 6, 2018 Accepting new patients
Huron Regional Medical Center Inc CurrentSince Sep 8, 2015 Accepting new patients
Huron Laboratory SVC PC Current Accepting new patients

Locations

172 4th St SE
Huron, SD 57350
Phone (605) 353-6593

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1376929000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510",
            "city": "BRITTON",
            "state": "SD",
            "postal_code": "574300510",
            "telephone_number": "605-470-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 4TH ST SE",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502510",
            "telephone_number": "605-353-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNGAAS",
        "first_name": "JACOB",
        "credential": "MPA, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huron, SD

Sources for this page

Verify at the official NPI Registry.