Jonathan Dean Medeck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0361 Issued in SD

Practice address

710 Saint Anne Street
Rapid City, SD 57701-4670

Phone

(605) 343-8000

Fax

(605) 343-8262

NPI assigned

Feb 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SD, CO2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Center of Steamboat Springs, LLC a Professional LLCGroup PAC ID 8123115623, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Dermatology Center of Steamboat Springs, LLC a Professional LLC

  • Specialist
  • Steamboat Springs, CO
  • NPI 1215157029
  Medicare reassignment Care Compare group NPD
• Advanced Dermatology Center, PC

  • Dermatology Physician
  • Rapid City, SD
  • NPI 1346389178
  Medicare reassignment

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1467426387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3468",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577093468",
            "telephone_number": "605-343-8000",
            "fax_number": "605-343-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 SAINT ANNE STREET",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014670",
            "telephone_number": "605-343-8000",
            "fax_number": "605-343-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDECK",
        "first_name": "JONATHAN",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SD",
            "license": "0361",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070013292",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6826630",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina McVay, OT
• Meadowbrook Care and Rehabilitation Center LLC
• Tara Mechaley, LMT
• Taylor Joseph Mechaley, LMT
• Marcus Vernon Medalen, PT
• Medical Arts Clinic, Pro. L.L.C.
• Medical Associates of the Black Hillc, LLC.
• Marisa Claudette Medina, MD
• Molly Meehan-Rasby
• Jennifer Mees, M.S. CCC-SLP

• Physician Assistant in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.