NPIMap

Individual provider Active NPI

Karl Kenneth Oehlke, PA

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1497727929
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0542 Issued in SD
Practice address
4400 W 69TH St
Ste 1500
Sioux Falls, SD 57108-8170
Phone
(605) 322-5700
Fax
(605) 322-5704
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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 0542 SD Primary

Addresses

Primary practice location

4400 W 69TH St
Ste 1500
Sioux Falls, SD 57108-8170

Mailing address

2400 S Minnesota Ave
Ste 100
Sioux Falls, SD 57105-3761
Phone (605) 322-7510

Other identifiers 16

IdentifierTypeStateIssuer
352157500MedicaidMN
9238091OtherSDDAKOTACARE
040121002OtherMNPRIMEWEST
12200MedicaidND
30791OtherSDSANFORD HEALTH PLAN
241L9OEOtherMNCC SYSTEMS/ BLUE PLUS
46022474352MedicaidNE
3148379MedicaidIA
57108C027OtherSDWPS TRICARE
1931128OtherSDARAZ/ AMERICA'S PPO
370624200OtherSDDEPT OF LABOR
6825460MedicaidSD
241098OtherSDMIDLANDS CHOICE
412991034954OtherSDPREFERRED ONE
4995860OtherSDBLUE CROSS
HP39461OtherSDHEALTHPARTNERS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040302000331 SD Practitioner - Physician Assistant 1951298231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennan 957 clinicians

Practice addresses (Care Compare)

4400 W 69TH St
Suite 500
Sioux Falls, SD 57108-8171
Phone (605) 322-7580

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

State licenses

LicenseStateTypeSpecialty
0542SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 15, 2003 Accepting new patients
Avera McKennan CurrentSince Sep 15, 2003 Accepting new patients
Southeastern Behavioral Healthcare Past Accepting new patients

Locations

400 22nd Ave
Brookings, SD 57006
Phone (605) 692-6236

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

1000 E 23rd St
Sioux Falls, SD 57105
Phone (605) 322-2100

Interoperability endpoints

  • Direct secure messaging: karl.oehlke@avera.sdhealthlink.net

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 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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1497727929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S MINNESOTA AVE",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571053761",
            "telephone_number": "605-322-7510",
            "fax_number": "605-322-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 69TH ST",
            "address_2": "STE 1500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088170",
            "telephone_number": "605-322-5700",
            "fax_number": "605-322-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OEHLKE",
        "first_name": "KARL",
        "middle_name": "KENNETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352157500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9238091",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "040121002",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12200",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANFORD HEALTH PLAN",
            "identifier": "30791",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CC SYSTEMS/ BLUE PLUS",
            "identifier": "241L9OE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46022474352",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3148379",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "57108C027",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/ AMERICA'S PPO",
            "identifier": "1931128",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "370624200",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6825460",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "241098",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "412991034954",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4995860",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP39461",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.