NPIMap

Individual provider Active NPI

Michael Ricard Puumala, MD

  • Neurological Surgery Physician
  • Sioux Falls, SD
National Provider Identifier
1821021304
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4116 Issued in SD
Practice address
1301 S. Cliff Ave
Ste 610
Sioux Falls, SD 57105-1032
Phone
(605) 322-8860
Fax
(605) 322-8868
NPI assigned
Jul 8, 2006
Last updated
Oct 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4116 SD Primary

Addresses

Primary practice location

1301 S. Cliff Ave
Ste 610
Sioux Falls, SD 57105-1032

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510

Other identifiers 12

IdentifierTypeStateIssuer
6100473MedicaidSD
C83141030612OtherPREFERRED ONE
41161OtherSDDAKOTACARE
232615OtherSDMIDLANDS CHOICE
4992697OtherSDBLUE CROSS
10025568900MedicaidNE
1821021304MedicaidIA
57105AT03OtherSDWPS TRICARE
46L91PUOtherMNCC SYSTEMS/ BLUE PLUS
HP43169OtherSDHEALTHPARTNERS
1821021304OtherSDARAZ/ AMERICA'S PPO
820816600MedicaidMN

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
I20040823000121 SD Practitioner - Neurosurgery 4385618941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Mayo Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1301 S Cliff Ave
Suite 610
Sioux Falls, SD 57105-1032
Phone (605) 322-8860

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4116SDMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Oct 1, 2007 Accepting new patients
Avera McKennan Neurological Surgery CurrentSince Oct 1, 2007 Accepting new patients
Avera McKennan Current Accepting new patients
Ashtabula Surgery Center LLC PastSince Jan 1, 2012 Accepting new patients

Locations

1301 S Cliff Ave
Ste 610
Sioux Falls, SD 57105
Phone (605) 322-8860

911 E 20th St
Ste 400
Sioux Falls, SD 57105
Phone (605) 322-8860

Interoperability endpoints

  • Direct secure messaging: michael.puumala@avera.sdhealthlink.net

Organizations & group practices 4

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1821021304",
    "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": "605-322-7510",
            "fax_number": "605-322-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S. CLIFF AVE",
            "address_2": "STE 610",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051032",
            "telephone_number": "605-322-8860",
            "fax_number": "605-322-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUUMALA",
        "first_name": "MICHAEL",
        "middle_name": "RICARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "SD",
            "license": "4116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6100473",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "C83141030612",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "41161",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "232615",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4992697",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025568900",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821021304",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "57105AT03",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CC SYSTEMS/ BLUE PLUS",
            "identifier": "46L91PU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP43169",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/ AMERICA'S PPO",
            "identifier": "1821021304",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "820816600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.