NPIMap

Individual provider Active NPI

Krystal Niesen, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1639610116
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1078 Issued in SD
Practice address
1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4647
Phone
(605) 328-2663
NPI assigned
Mar 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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 1078 SD Primary

Addresses

Primary practice location

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4647

Mailing address

1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4647
Phone (605) 328-2663

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kniesen9462398@direct.sanfordhealth.org

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
I20170601002929 SD Practitioner - Physician Assistant 1153698717 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

6100 S Louise Ave
Sioux Falls, SD 57108-6029

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1078SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Dec 9, 2024 Accepting new patients
Avera McKennan CurrentSince Dec 9, 2024 Accepting new patients
Sanford Medical Center Physician Assistant CurrentSince Apr 19, 2017 Accepting new patients
Sanford Clinic Physician Assistant CurrentSince Apr 19, 2017 Accepting new patients
Sanford Clinic CurrentSince Apr 19, 2017 Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

6100 S Louise Ave
Ste 1500
Sioux Falls, SD 57108
Phone (605) 504-1100

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

1210 W 18th St
Ste G01
Sioux Falls, SD 57104
Phone (605) 328-1395

6100 S Louise Ave
Ste 2100
Sioux Falls, SD 57108
Phone (605) 504-1100

6800 S Louise Ave
Sioux Falls, SD 57108
Phone (605) 322-3278

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

Interoperability endpoints

  • Direct secure messaging: krystal.niesen@avera.sdhealthlink.net

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 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": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1639610116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "SUITE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044647",
            "telephone_number": "605-328-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST",
            "address_2": "SUITE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044647",
            "telephone_number": "605-328-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIESEN",
        "first_name": "KRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kniesen9462398@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1210 W 18th St",
            "address_2": "Suite G01",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571044647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.