NPIMap

Individual provider Active NPI

Phillip E Meehan, PA

  • Surgical Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1609809094
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0571 Issued in SD
Practice address
1301 S. Cliff Ave
Ste 610
Sioux Falls, SD 57105-1032
Phone
(605) 322-8860
Fax
(605) 322-8868
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0571 SD Primary

Addresses

Primary practice location

1301 S. Cliff Ave
Ste 610
Sioux Falls, SD 57105-1032

Mailing address

2400 S. Minnesota Ave
Ste 100
Sioux Falls, SD 57105-3762
Phone (605) 322-7510

Other identifiers 12

IdentifierTypeStateIssuer
10025568900MedicaidNE
1821021304MedicaidIA
9238709OtherSDDAKOTACARE
46L92MEOtherMNCC SYSTEMS/ BLUE PLUS
4992676OtherSDBLUE CROSS
1609809094OtherSDARAZ/ AMERICA'S PPO
248340OtherSDMIDLANDS CHOICE
0127834OtherSDMEDICA
248340OtherSDMIDLAND'S CHOICE
6827152MedicaidSD
C83141041559OtherSDPREFERRED ONE
57105AT04OtherSDWPS TRICARE

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
I20040823000294 SD Practitioner - Physician Assistant 7113991506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1100 E 21St St
Suite 610
Sioux Falls, SD 57105-1053
Phone (605) 322-8860

1301 S Cliff Ave
Sioux Falls, SD 57105-1023

1301 S Cliff Ave
Suite 610
Sioux Falls, SD 57105-1032
Phone (605) 322-8860

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Lakes Regional Healthcare Hospital, Spirit Lake, IA, CCN 160124

Merit-based Incentive Payment System (MIPS)

Final score
96.04 of 100Reported as apm
Quality
89.99
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0571SDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Oct 1, 2007 Accepting new patients
Avera McKennan CurrentSince Oct 1, 2007 Accepting new patients
Avera McKennan Past Accepting new patients

Locations

1301 S Cliff Ave
Ste 610
Sioux Falls, SD 57105
Phone (605) 322-8860

1301 S Cliff Ave
Ste 401
Sioux Falls, SD 57105
Phone (605) 322-7300

911 E 20th St
Ste 400
Sioux Falls, SD 57105
Phone (605) 322-8860

Interoperability endpoints

  • Direct secure messaging: phillip.meehan@avera.sdhealthlink.net

Organizations & group practices 4

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1609809094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S. MINNESOTA AVE",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571053762",
            "telephone_number": "605-322-7510",
            "fax_number": "605-322-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S. CLIFF AVE",
            "address_2": "STE 610",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051032",
            "telephone_number": "605-322-8860",
            "fax_number": "605-322-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEHAN",
        "first_name": "PHILLIP",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SD",
            "license": "0571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025568900",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821021304",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9238709",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CC SYSTEMS/ BLUE PLUS",
            "identifier": "46L92ME",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4992676",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/ AMERICA'S PPO",
            "identifier": "1609809094",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "248340",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0127834",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE",
            "identifier": "248340",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6827152",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "C83141041559",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "57105AT04",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.