NPIMap

Individual provider Active NPI

Daniel Todd Mullin, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1497273288
Registry record updated Sep 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1101 Issued in SD
Practice address
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone
(605) 929-7936
NPI assigned
Sep 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2017

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 1101 SD Primary

Addresses

Primary practice location

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Mailing address

5113 S Graystone Ave Unit 3
Sioux Falls, SD 57108-8581
Phone (605) 929-7936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171030003375 SD Practitioner - Physician Assistant 9133495500 Reassigns benefits to 1 organization
I20190507000262 TX Practitioner - Physician Assistant 9133495500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1200 S 7TH Ave
Sioux Falls, SD 57105-0900
Phone (605) 336-2140

2100 S Marion Rd
Sioux Falls, SD 57106-3646
Phone (605) 322-5180

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 28, 2017 Accepting new patients
Avera McKennan CurrentSince Sep 28, 2017 Accepting new patients
Landmann Jungman Memorial Hospital Corporation CurrentSince Jun 5, 2018 Accepting new patients
Flandreau Santee Sioux Tribe PastSince May 31, 2020 Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

600 Billars St
Scotland, SD 57059
Phone (605) 583-2226

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

1200 S 7th Ave
Sioux Falls, SD 57105
Phone (605) 336-2140

Organizations & group practices 7

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504224000000",
    "number": "1497273288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 S GRAYSTONE AVE UNIT 3",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088581",
            "telephone_number": "605-929-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-929-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "DANIEL",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-01",
        "last_updated": "2017-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.