NPIMap

Individual provider Active NPI

Stephanie M Ideker, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1609213339
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0868 Issued in SD
Practice address
201 W 69TH St
Sioux Falls, SD 57108
Phone
(605) 336-0635
Fax
(605) 271-0543
NPI assigned
Jun 4, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 8

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 27

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

View all 27

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Specialists Chartered 47 clinicians

Practice addresses (Care Compare)

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 328-7882

201 W 69TH St
Sioux Falls, SD 57108-2403
Phone (605) 336-0635

4500 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-7000

910 E 20TH St
Sioux Falls, SD 57105-1012
Phone (605) 334-6730

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027
  • Pipestone County Medical Center Hospital, Pipestone, MN, CCN 241374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20130820001026 SD Practitioner - Physician Assistant 7719120807 Reassigns benefits to 4 organizations
I20220323001845 IA Practitioner - Physician Assistant 7719120807 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0868SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince Jun 13, 2015 Accepting new patients
Sanford Health Network CurrentSince Jun 13, 2015 Accepting new patients
Sanford Clinic CurrentSince Jul 8, 2013 Accepting new patients
Sanford Medical Center Physician Assistant CurrentSince Jul 8, 2013 Accepting new patients
Sanford Clinic CurrentSince Jul 8, 2013 Accepting new patients

Locations

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

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

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

1508 W 22nd St
Ste 101
Sioux Falls, SD 57105
Phone (605) 328-3840

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

Interoperability endpoints

  • Direct secure messaging: stephanie.ideker.p1@direct.urologyspecialists.nextgenshare.com
  • Direct secure messaging: sideker@urologyspecialists.gwaydirect.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0868 SD Primary

Addresses

NPPES NPI Registry

Primary practice location

201 W 69TH St
Sioux Falls, SD 57108

Mailing address

201 W 69TH St
Sioux Falls, SD 57108-2403
Phone (605) 336-0635

Other practice location 1

1508 W 22nd St Ste 101
Sioux Falls, SD 57105-1514
Phone (605) 328-3840

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 2, 2019.

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1609213339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082403",
            "telephone_number": "605-336-0635",
            "fax_number": "605-271-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57108",
            "telephone_number": "605-336-0635",
            "fax_number": "605-271-0543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1508 W 22nd St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051514",
            "country_code": "US",
            "telephone_number": "605-328-3840",
            "fax_number": "605-328-3841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDEKER",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.