NPIMap

Individual provider Active NPI

Jesse Lee Dirksen, M.D.

  • Surgery Physician
  • Sioux Falls, SD
National Provider Identifier
1730389941
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
8404 Issued in SD
Practice address
1508 W 22ND St Ste 101
Sioux Falls, SD 57105-1514
Phone
(605) 328-3840
Fax
(605) 328-3841
NPI assigned
Jul 25, 2007
Last updated
Feb 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT189424 PA
Surgery Physician 208600000X 8404 SD Primary

Addresses

Primary practice location

1508 W 22ND St Ste 101
Sioux Falls, SD 57105-1514

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120814000047 SD Practitioner - General Surgery 3476715301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Sanford School of Medicine of University of South Dakota, 2006
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)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

1309 W 17TH St
Sioux Falls, SD 57104-8805

1508 W 22ND St
Suite 101
Sioux Falls, SD 57105-1514
Phone (605) 328-3840

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

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy34
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT189424PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Surgery CurrentSince Jul 9, 2012 Accepting new patients
Sanford Clinic CurrentSince Jul 9, 2012 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Jul 9, 2012 Accepting new patients
Sanford Medical Center CurrentSince Jul 9, 2012 Accepting new patients
Sanford Clinic Past 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

1508 W 22nd St
Ste 101
Sioux Falls, SD 57105
Phone (605) 328-3840

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

Organizations & group practices 6

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 3

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1730389941",
    "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": "1508 W 22ND ST STE 101",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051514",
            "telephone_number": "605-328-3840",
            "fax_number": "605-328-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKSEN",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT189424",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "8404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.