Individual provider Active NPI

Mariah Eastman, PA

  • Physician Assistant
  • Sisseton, SD
National Provider Identifier
1730858473
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
205 Orchard Dr
Sisseton, SD 57262-2312
Phone
(605) 698-7647
Fax
(605) 698-3493
NPI assigned
Sep 7, 2021
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

205 Orchard Dr
Sisseton, SD 57262-2312

Mailing address

205 Orchard Dr
Sisseton, SD 57262
Phone (605) 698-7647

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125003094 SD Practitioner - Physician Assistant 7113311911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coteau Des Prairies HospitalGroup PAC ID 8022926468, 11 clinicians

Practice addresses (Care Compare)

205 Orchard Dr
Sisseton, SD 57262-2312
Phone (605) 698-7647

205 Orchard Dr
Sisseton, SD 57262-2398

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coteau Des Prairies Hospital CurrentSince Jan 8, 2024 Accepting new patients
Coteau Des Prairies Hospital CurrentSince Jan 8, 2024 Accepting new patients
Coteau Des Prairies Hospital,Inc Past Accepting new patients
Coteau Des Prairies Hospital Past Accepting new patients
Coteau Des Prairies Hospital Past Accepting new patients

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 1

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1730858473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ORCHARD DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "57262",
            "telephone_number": "605-698-7647",
            "fax_number": "605-698-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ORCHARD DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572622312",
            "telephone_number": "605-698-7647",
            "fax_number": "605-698-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "MARIAH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sisseton, SD

Sources for this page

Verify at the official NPI Registry.