NPIMap

Individual provider Active NPI

Ellen Olivia Farrell, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1386350171
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1420 Issued in SD
Practice address
1301 S Cliff Ave Ste 506
Sioux Falls, SD 57105-1023
Phone
(605) 504-0100
Fax
(605) 504-0159
NPI assigned
Jan 25, 2023
Reactivated
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 1420 SD Primary

Addresses

Primary practice location

1301 S Cliff Ave Ste 506
Sioux Falls, SD 57105-1023

Mailing address

1301 S Cliff Ave Ste 506
Sioux Falls, SD 57105-1023
Phone (605) 504-0100

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
I20230313002645 SD Practitioner - Physician Assistant 9234503384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
St Michael'S Hospital, Inc.Group PAC ID 2668380262, 16 clinicians

Practice addresses (Care Compare)

1301 S Cliff Ave
Sioux Falls, SD 57105-1023

1301 S Cliff Ave
Suite 610
Sioux Falls, SD 57105-1032
Phone (605) 322-8860

410 W 16TH Ave
Tyndall, SD 57066-2318
Phone (605) 589-2158

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005
  • Spencer Municipal Hospital Hospital, Spencer, IA, CCN 160112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1420SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Nov 20, 2023 Accepting new patients
Avera McKennan CurrentSince Nov 20, 2023 Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

1301 S Cliff Ave
Ste 610
Sioux Falls, SD 57105
Phone (605) 322-8860

1301 S Cliff Ave
Ste 506
Sioux Falls, SD 57105
Phone (605) 335-0844

Interoperability endpoints

  • Direct secure messaging: ellen.farrell@avera.sdhealthlink.net

Organizations & group practices 10

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1386350171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE STE 506",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051023",
            "telephone_number": "605-504-0100",
            "fax_number": "605-504-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE STE 506",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051023",
            "telephone_number": "605-504-0100",
            "fax_number": "605-504-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "ELLEN",
        "middle_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "deactivation_date": "2023-01-25",
        "reactivation_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.