NPIMap

Organization Active NPI

Avera St Lukes

  • Radiation Oncology Physician
  • Aberdeen, SD
National Provider Identifier
1780004713
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
AVERA ST LUKES
Practice address
310 S Penn St Ste 105
Aberdeen, SD 57401-4553
Phone
(605) 622-5500
Fax
(605) 622-5042
NPI assigned
Apr 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Authorized official

Name
Daniel J Bjerknes
Title
President/Ceo
Phone
(605) 622-5125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X SD Primary

Addresses

Primary practice location

310 S Penn St Ste 105
Aberdeen, SD 57401-4553

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-4933

Other practice location 1

415 9th St
Britton, SD 57430-2274
Phone (605) 622-5500

Other identifiers 1

IdentifierTypeStateIssuer
S101808OtherSDMEDICARE

Other names 2

  • Avera Medical Group Radiation Oncology Aberdeen Doing business as
  • Avera Radiation Oncology Aberdeen Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000912 SD Part B Supplier - Clinic/Group Practice 6406764927 Receives reassigned benefits from 271 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, SD; Waubay, SD; Redfield, SD; Mobridge, SD; Groton, SD; Faulkton, SD; Britton, SD

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Tax ID family
St Luke Mid Reg Hospdm25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777507200000",
    "number": "1780004713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-4933",
            "fax_number": "605-504-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S PENN ST STE 105",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014553",
            "telephone_number": "605-622-5500",
            "fax_number": "605-622-5042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 9th St",
            "address_purpose": "LOCATION",
            "city": "Britton",
            "state": "SD",
            "postal_code": "574302274",
            "country_code": "US",
            "telephone_number": "605-622-5500",
            "fax_number": "605-622-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVERA ST LUKES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A",
        "authorized_official_last_name": "BJERKNES",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-622-5125"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "S101808",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Radiation Oncology Aberdeen",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Radiation Oncology Aberdeen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.