NPIMap

Individual provider Active NPI

Renee L Blaha, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1396700449
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0499 Issued in SD
Practice address
1210 W 18TH St Ste G01
Sioux Falls, SD 57104-4651
Phone
(605) 328-2663
NPI assigned
Apr 20, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1962 WI
Physician Assistant 363A00000X 9828 MN
Physician Assistant 363A00000X 0499 SD Primary

Addresses

Primary practice location

1210 W 18TH St Ste G01
Sioux Falls, SD 57104-4651

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other identifiers 1

IdentifierTypeStateIssuer
1396700449MedicaidMN

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
I20120521000218 SD Practitioner - Physician Assistant 8123007697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
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)

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4651
Phone (605) 328-2663

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

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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001258IAMDCounselor
805NEMDSurgery Physician
0499SDMDOccupational Therapist
9828MNMDPhysician Assistant
1962WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince Apr 16, 2012 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Medical Center CurrentSince Aug 9, 2012 Accepting new patients
Niobrara Valley Hospital Corporation Past Accepting new patients
Sanford Clinic Past Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients
Sanford Clinic Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/niobra-b6726789

Organizations & group practices 8

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 3

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1396700449",
    "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": "605-328-6585",
            "fax_number": "605-312-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST STE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044651",
            "telephone_number": "605-328-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAHA",
        "first_name": "RENEE",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1962",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9828",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396700449",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.