Gabriel Penaredondo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12187 Issued in MN

Practice address

1301 W 18TH St
Sioux Falls, SD 57105-0401

Phone

(605) 312-2100

NPI assigned

Jun 29, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford ClinicGroup PAC ID 0244143824, 268 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Sanford Clinic

  • Psychologist
  • Sioux Falls, SD
  • NPI 1396764254
  Medicare reassignment Care Compare group
• Sanford Clinic

  • Vascular Surgery Physician
  • Sioux Falls, SD
  • NPI 1609808906
  NPD
• Sanford Clinic

  • Diagnostic Radiology Physician
  • Fargo, ND
  • NPI 1306641345
  NPD
• Sanford Clinic

  • Cardiovascular Disease Physician
  • Sioux Falls, SD
  • NPI 1144259052
  NPD (past)

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

• Sanford Medical Center

  • Air Ambulance
  • Sioux Falls, SD
  • NPI 1023299708

  Hospital

  Care Compare affiliation
• Sanford Medical Center

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

  Hospital

  Care Compare affiliation
• Sanford 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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1700237997",
    "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": "1301 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-312-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENAREDONDO",
        "first_name": "GABRIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon A Peer, LN
• Hillary Ayn Peirce, PA-C
• Michael Wayne Pekas
• Christina Jean Pekoske
• Aaron Pemberton, M.D.
• Mikaela A Penaredondo, PA-C
• Anita A Pendo, CNP
• Paul G Penn, OD
• Brian Sabado Pepito, M.D.
• Rebecca Jean Peppel, OTR/L

• 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 Jan 22, 2024; 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.