Stacy Henry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1210 W 18TH St Ste G01
Sioux Falls, SD 57104-4651

Phone

(605) 328-2663

NPI assigned

Jun 14, 2021

Last updated

Dec 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Yale University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanford Medical Center

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Sanford Medical Center

  dba Sanford Clinic Lake Norden

  • Rural Health Clinic/Center
  • Lake Norden, SD
  • NPI 1417927559
  NPD
• Sanford Clinic

  dba Sanford 4th and Sycamore Family Medicine

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1265461065
  NPD (past)

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

• Sanford Medical Center

  dba Sanford USD Medical Center

  • Air Ambulance
  • Sioux Falls, SD
  • NPI 1023299708

  Hospital

  Care Compare affiliation
• Sanford Medical Center

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342

  Hospital

  Care Compare affiliation
• Sanford Medical Center

  dba Sanford USD Medical Center

  • General Acute Care Hospital
  • Sioux Falls, SD
  • NPI 1821017880
  Care Compare affiliation

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1679141964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST STE G01",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044651",
            "telephone_number": "605-328-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3385 Dexter Ct",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528073494",
            "country_code": "US",
            "telephone_number": "563-344-9292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "111084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "111804",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody Lonnie Henriksen, DDS
• Anasara Henry, DNP, AGPCNP-BC
• Emily Henry, ED.S
• Jason D Henry, DC, CCSP
• Scott D Henry, M.D.
• Mikala Henzlik, PHARMD, RPH, MS, RD
• Karle Hepner, RN
• Cheryl L Hepp, CRNA
• Nicole Marie Hepper, PHARMD
• Brianna L Heppler, LMFT

• Physician Assistant in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.