Individual provider Active NPI

Lea Rae Niederbaumer, CNP

  • Family Nurse Practitioner
  • Aberdeen, SD
National Provider Identifier
1457019150
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP002226 Issued in SD
Practice address
3015 3Rd Ave SE
Aberdeen, SD 57401-5418
Phone
(605) 226-5500
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP002226 SD Primary

Addresses

Primary practice location

3015 3Rd Ave SE
Aberdeen, SD 57401-5418

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

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
I20220817002943 SD Practitioner - Nurse Practitioner 5991188377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Practice addresses (Care Compare)

1015 3Rd Ave SE
Aberdeen, SD 57401-5418
Phone (605) 725-1700

110 5TH Ave
Ipswich, SD 57451-2038
Phone (605) 426-6040

20 S Plum St
Vermillion, SD 57069-3346
Phone (605) 624-9111

3015 3Rd Ave SE
Aberdeen, SD 57401-5418
Phone (605) 725-1700

701 3Rd Ave S
Clear Lake, SD 57226-2016
Phone (605) 874-2141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
80.98
Promoting interoperability
100
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince May 6, 2022 Accepting new patients
Sanford Health Network Current Accepting new patients
Sanford Health Network Past Accepting new patients

Locations

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

110 5th Ave
Ipswich, SD 57451
Phone (605) 426-4072

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

Organizations & group practices 4

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 2

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1457019150",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 3RD AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574015418",
            "telephone_number": "605-226-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERBAUMER",
        "first_name": "LEA",
        "middle_name": "RAE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP002226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.