NPIMap

Individual provider Active NPI

Anthony M Vaca, M.D.

  • Psychiatry Physician
  • Sioux Falls, SD
National Provider Identifier
1700858248
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
3598 Issued in SD
Practice address
4400 W 69TH St.
Ste. 1500
Sioux Falls, SD 57108-8171
Phone
(605) 322-5700
Fax
(605) 322-5704
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 3598 SD Primary

Addresses

Primary practice location

4400 W 69TH St.
Ste. 1500
Sioux Falls, SD 57108-8171

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510

Other identifiers 18

IdentifierTypeStateIssuer
57108D004OtherSDWPS TRICARE
7100903MedicaidSD
0002435OtherSDBLUE CROSS
25001OtherSDSANFORD HEALTH PLAN
595989OtherSDARAZ/ AMERICA'S PPO
769191017551OtherSDPREFERRED ONE
3598OtherSDDAKOTACARE
HP24839OtherSDHEALTHPARTNERS
160062OtherMNUCARE
074783100MedicaidMN
12242MedicaidND
14787OtherSDMIDLANDS CHOICE
260040365OtherSDRR MEDICARE
92411422904OtherMNPRIMEWEST
7100902MedicaidSD
37B91VAOtherMNCC SYSTEMS/ BLUE PLUS
1993774MedicaidIA
46022474340MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060421000166 SD Practitioner - Psychiatry 8123038023 Reassigns benefits to 1 organization
I20140910000601 ND Practitioner - Psychiatry 8123038023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Sanford School of Medicine of University of South Dakota, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4400 W 69TH St
Suite 1500
Sioux Falls, SD 57108-8171

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3598SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
PSJ Acquisition LLC Psychiatry CurrentSince Jun 27, 2014 Accepting new patients
Avera McKennan Psychiatry CurrentSince Jul 13, 2011 Accepting new patients
Avera McKennan Current Accepting new patients
PSJ Acquisition LLC CurrentSince Jun 27, 2014 Accepting new patients
Avera McKennan CurrentSince Jul 13, 2011 Accepting new patients
Southeastern Behavioral Healthcare CurrentSince Sep 16, 2021 Accepting new patients
Southeastern Behavioral Healthcare Past Accepting new patients
Avera McKennan Psychiatry Past Accepting new patients

Locations

510 4th St S
Fargo, ND 58103
Phone (701) 476-7200

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

3932 S Western Ave
Sioux Falls, SD 57105
Phone (605) 322-6408

100 W 5th St
Sioux Falls, SD 57104
Phone (605) 271-2338

2000 S Summit Ave
Sioux Falls, SD 57105
Phone (605) 336-0503

Interoperability endpoints

  • Direct secure messaging: anthony.vaca@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1700858248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-7510",
            "fax_number": "605-322-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 69TH ST.",
            "address_2": "STE. 1500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088171",
            "telephone_number": "605-322-5700",
            "fax_number": "605-322-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACA",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "3598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "57108D004",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100903",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0002435",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANFORD HEALTH PLAN",
            "identifier": "25001",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/ AMERICA'S PPO",
            "identifier": "595989",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "769191017551",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "3598",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP24839",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "160062",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074783100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12242",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "14787",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "260040365",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "92411422904",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100902",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CC SYSTEMS/ BLUE PLUS",
            "identifier": "37B91VA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1993774",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46022474340",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.