Individual provider Active NPI

Brady J Stocklin, MD

  • Anesthesiology Physician
  • Sioux Falls, SD
National Provider Identifier
1487735312
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
49056 Issued in MN
Practice address
1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone
(605) 328-0681
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 49056 MN Primary

Addresses

Primary practice location

1305 W 18TH St
Sioux Falls, SD 57105-0401

Mailing address

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 328-0681

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN
071683100MedicaidMN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090821000575 SD Practitioner - Anesthesiology 1355349655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Sanford School of Medicine of University of South Dakota, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Physicians LTDGroup PAC ID 9133111438, 23 clinicians

Practice addresses (Care Compare)

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 386-1084

Hospital & facility affiliations

  • Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physicians LTD Anesthesiology CurrentSince Aug 1, 2009 Accepting new patients

Locations

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

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

Organizations & group practices 1

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 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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1487735312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-328-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-328-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKLIN",
        "first_name": "BRADY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "49056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071683100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.