Davis Bloemendaal, PA-C
Individual provider Active NPI Physician Assistant · Dakota Dunes, SD
NPI 1558037432 · NPPES record last updated Dec 29, 2022
Key facts
- NPI
- 1558037432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312 - Phone
- (605) 217-2667
- NPI assigned
- Aug 19, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cnos PC
Practice addresses (Care Compare)
1200 Providence Rd
Wayne, NE 68787-1212
Phone (402) 375-7953
201 E 4TH St
South Sioux City, NE 68776-9916
Phone (605) 217-2667
2735 Outer Dr N
Cnos Northside
Sioux City, IA 51104-1590
Phone (712) 224-5692
5708 Sunnybrook CT
Sioux City, IA 51106-4254
Phone (605) 217-2667
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667
600 N Sioux Point Rd
Dakota Dunes, SD 57049-5000
Phone (605) 232-3332
801 5TH St
Sioux City, IA 51101-1326
Phone (712) 279-2010
Hospital & facility affiliations
- Dunes Surgical Hospital
- Sioux Center Health
- St Lukes Regional Medical Center
- Orange City Area Health System
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.8 of 100
- Quality
- 82.54
- Promoting interoperability
- 89.05
- Improvement activities
- 40
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 (3 enrollments) in IA, SD, NE
- 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 |
|---|---|---|---|---|
| I20211220002700 | IA | Practitioner - Physician Assistant | 7416348776 | Reassigns benefits to 1 organization |
| I20211222000580 | SD | Practitioner - Physician Assistant | 7416348776 | Reassigns benefits to 1 organization |
| I20230322000364 | NE | Practitioner - Physician Assistant | 7416348776 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Cnos PC | Current |
Accepting new patients |
Locations
1101 9th St SE
Sioux Center, IA 51250
Phone (712) 722-1271
5708 Sunnybrook Ct
Sioux City, IA 51106
2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000
2735 Outer Dr N
Sioux City, IA 51104
Phone (712) 224-5692
1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800
575 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-2615
Interoperability endpoints
- davisbloemendaal@cnos.allscriptsdirect.net
- dbloemendaal894100@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Mailing address
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Other providers in Dakota Dunes, SD
- Kaylee Jo Bertrand
- Beth Bruening PC
- Benjamin T. Bissell
- William R Blankenship
- Sarah Bligh
- Michael Dale Bobier
- Erica Bonstead
- Erin Bonstead
- Andrew Elliott Bourne
- Jessica Lee Bowman
All providers in Dakota Dunes, 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 Dec 29, 2022. 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.