Individual provider Active NPI

Timothy P. Donelan, MD

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1730189325
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3836 Issued in SD
Practice address
6110 S Minnesota Ave
Sioux Falls, SD 57108-2549
Phone
(605) 332-2883
Fax
(605) 328-1855
NPI assigned
Jul 26, 2005
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3836 SD Primary

Addresses

Primary practice location

6110 S Minnesota Ave
Sioux Falls, SD 57108-2549

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other identifiers 1

IdentifierTypeStateIssuer
5608934MedicaidSD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tdonelan3857@direct.sanfordhealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051214000672 SD Practitioner - Family Practice 4183645476 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Family Medicine CurrentSince Feb 1, 2012 Accepting new patients
Sanford Clinic CurrentSince Jan 14, 2022 Accepting new patients
Sanford Clinic CurrentSince Jan 14, 2022 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Medical Center CurrentSince Feb 1, 2012 Accepting new patients

Locations

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

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

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

3401 W 49th St
Sioux Falls, SD 57106
Phone (605) 328-1850

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

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

Interoperability endpoints

  • Direct secure messaging: tdonelan3857@direct.sanfordhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1730189325",
    "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",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082549",
            "telephone_number": "605-332-2883",
            "fax_number": "605-328-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONELAN",
        "first_name": "TIMOTHY",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "3836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5608934",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdonelan3857@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "6110 S Minnesota Ave",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571082549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.