Russell C Pietz, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4105 Issued in SD

Practice address

305 S State St
Aberdeen, SD 57401-4527

Phone

(605) 622-5100

Fax

(605) 622-4030

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Internal MedicineAlso: Family Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera St Lukes Hospital, Aberdeen, SD, CCN 430014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: russell.pietz@avera.sdhealthlink.net

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.

• Avera St. Luke'S

  • Internal Medicine Physician
  • Aberdeen, SD
  • NPI 1215100813
  Medicare reassignment Care Compare group NPD
• Avera St. Luke'S

  • Psychiatry Physician
  • Aberdeen, SD
  • NPI 1649208695
  NPD
• Avera St. Lukes

  • Nephrology Physician
  • Aberdeen, SD
  • NPI 1477594430
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Avera St Lukes

  • General Acute Care Hospital
  • Aberdeen, SD
  • NPI 1457309270
  Care Compare affiliation

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1790789543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S STATE ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014527",
            "telephone_number": "605-622-5100",
            "fax_number": "605-622-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S STATE ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014527",
            "telephone_number": "605-622-5100",
            "fax_number": "605-622-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETZ",
        "first_name": "RUSSELL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003203",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003202",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11631",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Dawn Peterson, FNP-C
• Elizabeth Petkac, PHARMD
• Erica Pfaff, DPT
• Susan L Pfeiffer-Hanson, PA-C
• Dustin Pickrel
• Plains Edge Chiropractic, Inc.
• Brianna Lynn Podoll
• Troy Podoll, HAD
• Donald Pollard Jr., DDS
• Jamie Portra, SLP

• Family Medicine Physician in Aberdeen, SD
• Providers in Aberdeen, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.