Individual provider Active NPI

Justin David Tuntland

  • Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1538576871
Registry record updated Feb 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP000873 Issued in SD
Practice address
1210 W 18TH St
Ste 100
Sioux Falls, SD 57104-9890
Phone
(605) 312-8500
Fax
(605) 312-8501
NPI assigned
Jul 18, 2014
Last updated
Feb 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP000873 SD Primary
Family Nurse Practitioner 363LF0000X 00896893 SD

Addresses

Primary practice location

1210 W 18TH St
Ste 100
Sioux Falls, SD 57104-9890

Mailing address

PO Box 5074
Ste 104
Sioux Falls, SD 57117-5074

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141020001426 SD Practitioner - Nurse Practitioner 0840411617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

1420 W 22ND St
Sioux Falls, SD 57105-1507

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
00896893SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Nurse Practitioner CurrentSince Jul 28, 2014 Accepting new patients
Sanford Clinic Nurse Practitioner Past Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

2720 Dundee Rd
Northbrook, IL 60062
Phone (224) 226-5222

1210 W 18th St
Ste 100
Sioux Falls, SD 57104
Phone (605) 312-8500

1210 W 18th St
Ste 104
Sioux Falls, SD 57104
Phone (605) 328-8660

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

1420 W 22nd St
Ste 510
Sioux Falls, SD 57105
Phone (605) 328-7500

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Organizations & group practices 3

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 10

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": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613260800000",
    "number": "1538576871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "address_2": "STE 104",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571049890",
            "telephone_number": "605-312-8500",
            "fax_number": "605-312-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNTLAND",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-18",
        "last_updated": "2021-02-14",
        "certification_date": "2021-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP000873",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "00896893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.