Leonard Trent Wonnenberg, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0803 Issued in SD

Practice address

172 4TH St SE
Huron, SD 57350-2510

Phone

(605) 353-6200

Fax

(605) 353-6300

NPI assigned

Jan 25, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Sanford School of Medicine of University of South Dakota, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Huron Regional Medical Center IncGroup PAC ID 2769393388, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huron Regional Medical Center Hospital, Huron, SD, CCN 431335

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Huron Regional Medical Center Inc

  • Critical Access Hospital
  • Huron, SD
  • NPI 1154312429
  Medicare reassignment Care Compare group NPD
• Horizon Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Plankinton, SD
  • NPI 1356459382
  Medicare reassignment
• Horizon Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Yankton, SD
  • NPI 1013445907
  NPD
• Horizon Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Elk Point, SD
  • NPI 1841728730
  NPD
• Huron Laboratory SVC PC

  • Anatomic Pathology Physician
  • Huron, SD
  • NPI 1437155744
  NPD

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

• Huron Regional Medical Center Inc

  • Critical Access Hospital
  • Huron, SD
  • NPI 1154312429
  Care Compare affiliation

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1609147461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 4TH ST SE",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502590",
            "telephone_number": "605-353-6200",
            "fax_number": "605-353-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 4TH ST SE",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502510",
            "telephone_number": "605-353-6200",
            "fax_number": "605-353-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONNENBERG",
        "first_name": "LEONARD",
        "middle_name": "TRENT",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SD",
            "license": "0803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William a Cahill DDS
• Bruce Dale Wintle, DDS
• Wise Imaging Inc
• Women'S Wellness Center, Prof. L.L.C.
• Amanda Wonnenberg
• Larry Dale Young II, CRNA
• Bailey Zerfoss, MS, LPC SUPERVISEE

• Surgical Physician Assistant in Huron, SD
• Providers in Huron, SD by specialty
• Surgical Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.