Individual provider Active NPI

Jacqueline M Heisterkamp, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1689345050
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1408 Issued in SD
Practice address
1500 W 22ND St Ste 101
Sioux Falls, SD 57105-1503
Phone
(605) 328-0000
NPI assigned
Sep 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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 1408 SD Primary

Addresses

Primary practice location

1500 W 22ND St Ste 101
Sioux Falls, SD 57105-1503

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

414 East Clark St
Julian Hall Room 120
Vermillion, SD 57069
Phone (605) 658-5926

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
I20231215002117 SD Practitioner - Physician Assistant 2365891330 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
Sanford ClinicGroup PAC ID 0244143824, 268 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2100

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 328-8700

1500 W 22ND St
Sioux Falls, SD 57105-1503

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-5635

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
75.87
Promoting interoperability
100
Improvement activities
40
Cost
68.53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1408SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic Physician Assistant CurrentSince Nov 5, 2023 Accepting new patients
Sanford Clinic Past Accepting new patients
Upper Midwest Medical Inc PastSince Sep 1, 2021 Accepting new patients
Plastic Surgery Associates of South Dakota, LTD PastSince Sep 1, 2021 Accepting new patients

Organizations & group practices 5

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1689345050",
    "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": "1500 W 22ND ST STE 101",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051503",
            "telephone_number": "605-328-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 East Clark St",
            "address_2": "Julian Hall Room 120",
            "address_purpose": "LOCATION",
            "city": "Vermillion",
            "state": "SD",
            "postal_code": "57069",
            "country_code": "US",
            "telephone_number": "605-658-5926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEISTERKAMP",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.