Individual provider Active NPI

Mirtha Giuliana Gayoso Liviac, MD

  • Pediatric Pulmonology Physician
  • Sioux Falls, SD
National Provider Identifier
1730609017
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
14337 Issued in SD
Practice address
1417 S Cliff Ave Ste 10
Sioux Falls, SD 57105-1014
Phone
(605) 322-3666
NPI assigned
Jun 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 14337 SD Primary

Addresses

Primary practice location

1417 S Cliff Ave Ste 10
Sioux Falls, SD 57105-1014

Mailing address

1417 S Cliff Ave Ste 10
Sioux Falls, SD 57105-1014
Phone (605) 322-3666

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
I20231229002069 SD Practitioner - Pediatric Medicine 5890033856 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14337SDMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 10, 2023 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Sep 10, 2023 Accepting new patients

Locations

1417 S Cliff Ave
Ste 10
Sioux Falls, SD 57105
Phone (605) 322-3666

Interoperability endpoints

  • Direct secure messaging: mirtha.gayosoliviac@avera.sdhealthlink.net

Organizations & group practices 3

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1730609017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE STE 10",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051014",
            "telephone_number": "605-322-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE STE 10",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051014",
            "telephone_number": "605-322-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYOSO LIVIAC",
        "first_name": "MIRTHA",
        "middle_name": "GIULIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "SD",
            "license": "14337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.