NPIMap

Individual provider Active NPI

Marie Angelica Landicho Diaz, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Sioux Falls, SD
National Provider Identifier
1588072532
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
11482 Issued in SD
Practice address
1315 S Cliff Ave Ste 3000
Sioux Falls, SD 57105-1061
Phone
(605) 322-7600
NPI assigned
Jul 22, 2014
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 11482 SD Primary

Addresses

Primary practice location

1315 S Cliff Ave Ste 3000
Sioux Falls, SD 57105-1061

Mailing address

1315 S Cliff Ave Ste 3000
Sioux Falls, SD 57105-1061

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190905003421 SD Practitioner - Endocrinology 5395018725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

1600 S Highline Ave
Sioux Falls, SD 57110-1008

1600 S Highline Ave
Suite 310
Sioux Falls, SD 57110-1007
Phone (605) 322-7600

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 322-6930

911 E 20TH St
Suite 300
Sioux Falls, SD 57105-1045
Phone (605) 504-1100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 31, 2019 Accepting new patients
Avera McKennan CurrentSince Jul 31, 2019 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

1315 S Cliff Ave
Ste 3000
Sioux Falls, SD 57105
Phone (605) 322-7600

911 E 20th St
Ste 300
Sioux Falls, SD 57105
Phone (605) 322-1300

Interoperability endpoints

  • Direct secure messaging: marie.landicho@avera.sdhealthlink.net

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.

  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    Medicare reassignment Care Compare group NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera Medical Group Orthopedics and Sports Medicine

    • Orthopaedic Surgery Physician
    • Sioux Falls, SD
    • NPI 1093262131
    NPD

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1588072532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 S CLIFF AVE STE 3000",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S CLIFF AVE STE 3000",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051061",
            "telephone_number": "605-322-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MARIE ANGELICA",
        "middle_name": "LANDICHO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SD",
            "license": "11482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.