Individual provider Active NPI

Riley Jacob Knutson, PA

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1609447309
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
911 E 20TH St Ste 700
Sioux Falls, SD 57105-1049
Phone
(605) 334-0393
NPI assigned
Jul 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

911 E 20TH St Ste 700
Sioux Falls, SD 57105-1049

Mailing address

1107 S Dundee Dr
Sioux Falls, SD 57106-4922
Phone (605) 660-8997

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220106001759 SD Practitioner - Physician Assistant 2668863309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Institute of South Dakota PCGroup PAC ID 7911896253, 22 clinicians

Practice addresses (Care Compare)

1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 322-8000

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

911 E 20TH St
Suite 700
Sioux Falls, SD 57105-1049
Phone (605) 334-0393

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1327SDMDPhysical Therapist

Organizations & group practices 1

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1609447309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S DUNDEE DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571064922",
            "telephone_number": "605-660-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E 20TH ST STE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051049",
            "telephone_number": "605-334-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "RILEY",
        "middle_name": "JACOB",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-05",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.