NPIMap

Individual provider Active NPI

Ellis Rupert Easterling IV, MD

  • Hospitalist Physician
  • Sioux Falls, SD
National Provider Identifier
1508286931
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
12626 Issued in SC
Practice address
1321 W 22ND St
Sioux Falls, SD 57105-1502
Phone
(605) 404-4000
NPI assigned
Apr 24, 2014
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101259175 VA
Internal Medicine Physician 207R00000X 12626 SD
Hospitalist Physician 208M00000X 12626 SC Primary

Addresses

Primary practice location

1321 W 22ND St
Sioux Falls, SD 57105-1502

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Tennessee, HSC, College of Medicine, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25818 476TH Ave
Sioux Falls, SD 57104-6514

PO Box
Suite 5074
Sioux Falls, SD 57117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12626SDMDInternal Medicine Physician
12626SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic Current Accepting new patients
Sanford Medical Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1508286931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051502",
            "telephone_number": "605-404-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLING",
        "first_name": "ELLIS",
        "middle_name": "RUPERT",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-24",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101259175",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "12626",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "12626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.