Ronald Thomas Wren Jr., PA C
Individual provider Active NPI Physician Assistant · Redfield, SD
NPI 1497779805 · NPPES record last updated Jun 8, 2010
Key facts
- NPI
- 1497779805
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0621 (SD)
- Practice address
- 1010 W 1St St
Redfield, SD 57469-1506 - Phone
- (605) 472-0510
- Fax
- (605) 472-0331
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- City of Redfield
Practice addresses (Care Compare)
1010 W 1St St
Redfield, SD 57469-1502
Phone (605) 472-0510
111 W 10TH Ave
Redfield, SD 57469-1519
Phone (605) 475-7402
Hospital & facility affiliations
- Community Memorial Hospital
- Avera St Lukes
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.27 of 100
- Quality
- 85.98
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060802000135 | SD | Practitioner - Physician Assistant | 7911970454 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Redfield | Current |
Accepting new patients | |
| City of Redfield | Current |
Accepting new patients | |
| City of Redfield | Current |
Accepting new patients | |
| City of Redfield | Past |
Accepting new patients | |
| City of Redfield | Past | Accepting new patients |
Locations
111 W 10th Ave
Redfield, SD 57469
Phone (605) 472-1110
1010 W 1st St
Redfield, SD 57469
Phone (605) 472-0510
Interoperability endpoints
- ronald.wren@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0621 | SD | Yes |
Addresses
Primary practice location
1010 W 1St St
Redfield, SD 57469-1506
Mailing address
PO Box 590
Redfield, SD 57469-0590
Phone (605) 472-0510
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6822970 | Medicaid | SD |
Other providers in Redfield, SD
- Kayla Wagner
- Randall Waldner
- Cassandra Kay Weisz
- Alison Rose Winter
- Kristine Kay Wren
- Clay Lewis Yeoman
- Steven Dale Zaloudek
All providers in Redfield, SD · Physician Assistant in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.