Individual provider Active NPI

Abby Lynne Wookey, PA

  • Physician Assistant
  • Watertown, SD
National Provider Identifier
1457903833
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-7777
Fax
(605) 882-7819
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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 Primary

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

PO Box 1210
Watertown, SD 57201-6210
Phone (605) 882-7777

Other names 1

  • Abby Lynne Simon Former name

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
I20191025002332 SD Practitioner - Physician Assistant 9133451040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Mickelson Dr
Watertown, SD 57201-7231
Phone (605) 882-4743

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Hospital & facility affiliations

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
Prairie Lakes Health Care System Inc Physician Assistant CurrentSince Dec 14, 2021 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Dec 14, 2021 Accepting new patients

Locations

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

506 1st Ave SE
Watertown, SD 57201
Phone (605) 884-4247

511 14th Ave NE
Watertown, SD 57201
Phone (605) 330-9619

Organizations & group practices 2

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 5

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1457903833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016210",
            "telephone_number": "605-882-7777",
            "fax_number": "605-882-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7777",
            "fax_number": "605-882-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOKEY",
        "first_name": "ABBY",
        "middle_name": "LYNNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "SIMON",
            "middle_name": "LYNNE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.