NPIMap

Individual provider Active NPI

Jared Lee Mouw, PA-C

  • Physician Assistant
  • Vermillion, SD
National Provider Identifier
1558047191
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1505 Issued in SD
Practice address
20 S Plum St
Vermillion, SD 57069-3346
Phone
(605) 677-3700
NPI assigned
Jun 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1505 SD Primary
Physician Assistant 363A00000X 14544 MN

Addresses

Primary practice location

20 S Plum St
Vermillion, SD 57069-3346

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

916 4th Ave SW
Pipestone, MN 56164-1890
Phone (507) 825-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231026001354 MN Practitioner - Physician Assistant 3173979200 Reassigns benefits to 1 organization
I20240430003694 SD Practitioner - Physician Assistant 3173979200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of BrookingsGroup PAC ID 1052307105, 112 clinicians
Pipestone County Medical CenterGroup PAC ID 0840109682, 33 clinicians

Practice addresses (Care Compare)

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 692-6351

916 4TH Ave SW
Pipestone, MN 56164-1890
Phone (507) 825-5811

916 SW 4TH Ave
Pipestone, MN 56164-1890
Phone (507) 825-5811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City of Brookings CurrentSince Mar 16, 2024 Accepting new patients
City of Brookings CurrentSince Mar 16, 2024 Accepting new patients
Pipestone County Medical Center Avera CurrentSince Sep 4, 2023 Accepting new patients
Pipestone County Medical Center CurrentSince Sep 4, 2023 Accepting new patients
City of Brookings Current Accepting new patients
Sanford Health Network Past Accepting new patients

Locations

916 4th Ave SW
Pipestone, MN 56164
Phone (507) 825-5811

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

Organizations & group practices 9

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 6

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1558047191",
    "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",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S PLUM ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693346",
            "telephone_number": "605-677-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 4th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Pipestone",
            "state": "MN",
            "postal_code": "561641890",
            "country_code": "US",
            "telephone_number": "507-825-5811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUW",
        "first_name": "JARED",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1505",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vermillion, SD

Sources for this page

Verify at the official NPI Registry.