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Individual provider Active NPI

Micheala Renae Taylor, GTA- DO STUDENT

  • Family Medicine Physician
  • Aberdeen, SD
National Provider Identifier
1770053308
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15511 Issued in SD
Practice address
3015 3Rd Ave SE
Aberdeen, SD 57401-5418
Phone
(605) 226-5500
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 15511 SD Primary

Addresses

Primary practice location

3015 3Rd Ave SE
Aberdeen, SD 57401-5418

Mailing address

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

Other practice location 1

1464 North Jefferson Street
Lewisburg, WV 24901
Phone (304) 645-3220

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
I20240912000007 SD Practitioner - Family Practice 3476955949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Practice addresses (Care Compare)

1015 3Rd Ave SE
Aberdeen, SD 57401-5418
Phone (605) 725-1700

110 5TH Ave
Ipswich, SD 57451-2038
Phone (605) 426-6040

3015 3Rd Ave SE
Aberdeen, SD 57401-5418
Phone (605) 725-1700

701 3Rd Ave S
Clear Lake, SD 57226-2016
Phone (605) 874-2141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
80.98
Promoting interoperability
100
Improvement activities
40
Cost
70.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15511SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Family Medicine Current Accepting new patients
Sanford Health Network CurrentSince Jul 22, 2024 Accepting new patients
Sanford Health Network CurrentSince Jul 22, 2024 Accepting new patients
Sanford Health Network Family Medicine Past Accepting new patients
Sanford Health Network Past Accepting new patients

Locations

400 N Hiawatha Dr
Canton, SD 57013
Phone (605) 764-1500

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1770053308",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 3RD AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574015418",
            "telephone_number": "605-226-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1464 North Jefferson Street",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "WV",
            "postal_code": "24901",
            "country_code": "US",
            "telephone_number": "304-645-3220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHEALA",
        "middle_name": "RENAE",
        "credential": "GTA- DO STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "15511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.