Individual provider Active NPI

Stephanie Kreie, PAC

  • Physician Assistant
  • Brookings, SD
National Provider Identifier
1700839834
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0612 Issued in SD
Practice address
922 22ND Ave S
Brookings, SD 57006-2830
Phone
(605) 697-1900
Fax
(605) 697-1919
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0612 SD Primary
Physician Assistant 363A00000X 001682 IA

Addresses

Primary practice location

922 22ND Ave S
Brookings, SD 57006-2830

Mailing address

922 22ND Ave S
Brookings, SD 57006-2830
Phone (605) 697-1900

Other identifiers 1

IdentifierTypeStateIssuer
6828410MedicaidSD

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
I20060817000171 SD Practitioner - Physician Assistant 7012910821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
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)

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

922 22ND Ave S
Brookings, SD 57006-2830
Phone (605) 697-1900

Hospital & facility affiliations

  • Brookings Health System Hospital, Brookings, SD, CCN 430008
  • 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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001682IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Physician Assistant CurrentSince Nov 7, 2015 Accepting new patients
Sanford Clinic CurrentSince Dec 19, 2005 Accepting new patients
Sanford Clinic CurrentSince Dec 19, 2005 Accepting new patients
Sanford Medical Center CurrentSince Nov 7, 2015 Accepting new patients

Locations

922 22nd Ave S
Brookings, SD 57006
Phone (605) 697-1900

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1500 W 22nd St
Ste 102
Sioux Falls, SD 57105
Phone (605) 328-8800

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

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

6110 S Minnesota Ave
Sioux Falls, SD 57108
Phone (605) 328-5800

901 4th St NW
Watertown, SD 57201
Phone (605) 882-8780

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 7

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1700839834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062830",
            "telephone_number": "605-697-1900",
            "fax_number": "605-697-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062830",
            "telephone_number": "605-697-1900",
            "fax_number": "605-697-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIE",
        "first_name": "STEPHANIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0612",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6828410",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, SD

Sources for this page

Verify at the official NPI Registry.