Individual provider Active NPI

Benjamin Andrew Stukel, DC

  • Chiropractor
  • Gregory, SD
National Provider Identifier
1720170194
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1030 Issued in SD
Practice address
114 E 6TH St
Gregory, SD 57533
Phone
(605) 835-8737
Fax
(605) 835-8738
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1030 SD Primary

Addresses

Primary practice location

114 E 6TH St
Gregory, SD 57533

Mailing address

34605 284TH St
Burke, SD 57523
Phone (605) 775-9077

Other identifiers 2

IdentifierTypeStateIssuer
7601972MedicaidSD
10025344000OtherNEMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017000950 SD Practitioner - Chiropractic 7517983786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Healing Hands LLCGroup PAC ID 5597196220, 2 clinicians

Practice addresses (Care Compare)

114 E 6TH St
Gregory, SD 57533-1464
Phone (605) 835-8737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1030SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands, LLC Chiropractor CurrentSince Apr 10, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1720170194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34605 284TH ST",
            "city": "BURKE",
            "state": "SD",
            "postal_code": "57523",
            "telephone_number": "605-775-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E 6TH ST",
            "city": "GREGORY",
            "state": "SD",
            "postal_code": "57533",
            "telephone_number": "605-835-8737",
            "fax_number": "605-835-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUKEL",
        "first_name": "BENJAMIN",
        "middle_name": "ANDREW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7601972",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "10025344000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gregory, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.