NPIMap

Individual provider Active NPI

Stephanie O. Broderson, MD

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1437154606
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4547 Issued in SD
Practice address
4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone
(605) 328-9000
Fax
(605) 328-9001
NPI assigned
Jun 15, 2005
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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 4547 SD Primary

Addresses

Primary practice location

4405 E 26TH St
Sioux Falls, SD 57103-4187

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
5610682MedicaidSD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbroderson2624@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
I20051220000616 SD Practitioner - Family Practice 8224050141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 1995
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)

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

922 22ND Ave S
Brookings, SD 57006-2830
Phone (605) 697-1900

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 or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Family Medicine CurrentSince Feb 1, 2012 Accepting new patients
Sanford Clinic Family Medicine CurrentSince Feb 1, 2002 Accepting new patients
Sanford Clinic CurrentSince Feb 1, 2002 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

922 22nd Ave S
Brookings, SD 57006
Phone (605) 697-1900

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

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

1500 W 22nd St
Ste 102
Sioux Falls, SD 57105
Phone (605) 328-8800

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

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

Interoperability endpoints

  • Direct secure messaging: sbroderson2624@direct.sanfordhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1437154606",
    "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": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 E 26TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571034187",
            "telephone_number": "605-328-9000",
            "fax_number": "605-328-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERSON",
        "first_name": "STEPHANIE",
        "middle_name": "O.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5610682",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbroderson2624@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "4405 E 26th St",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571034187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.