Kirsten R. Dejean, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0271 Issued in SD

Practice address

3515 Broadway Ave
Yankton, SD 57078-7600

Phone

(605) 668-3100

Fax

(605) 668-3460

NPI assigned

Feb 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• State of South Dakota

  • Psychiatric Hospital
  • Yankton, SD
  • NPI 1124027586

  SD

  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710013610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 LAKEVIEW DR",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785111",
            "telephone_number": "605-665-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570787600",
            "telephone_number": "605-668-3100",
            "fax_number": "605-668-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJEAN",
        "first_name": "KIRSTEN",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Whitney J Delforge, CNP
• Joseph Raymond Dembouski, PA-C
• Patrick E Determan, D.C.
• David Dewitt, PT, DPT
• Diagnostic Radiology Services, Prof, LLC

• Physician Assistant in Yankton, SD
• Providers in Yankton, 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 Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.