NPIMap

Individual provider Active NPI

Chengetai Mahomva

  • Otolaryngology Physician
  • Sioux Falls, SD
National Provider Identifier
1841640778
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
12745273-1205 Issued in UT
Practice address
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone
(605) 504-3000
Fax
(605) 504-3001
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 12745273-1205 UT Primary

Addresses

Primary practice location

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Mailing address

1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 504-3000

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
I20230905002403 SD Practitioner - Otolaryngology 6406125814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Geisel School of Medicine at Dartmouth, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2114

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

1417 S Cliff Ave
Suite 300
Sioux Falls, SD 57105-1062
Phone (605) 504-3000

4500 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 322-9777

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 17, 2023 Accepting new patients
Avera McKennan CurrentSince Jul 17, 2023 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Interoperability endpoints

  • Direct secure messaging: chengetai.mahomva@avera.sdhealthlink.net

Organizations & group practices 3

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 McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    Medicare reassignment Care Compare group NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera Medical Group Intensivists Sioux Falls

    • Critical Care Medicine (Internal Medicine) Physician
    • Sioux Falls, SD
    • NPI 1972837979
    NPD

Hospital & facility affiliations 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1841640778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-504-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-504-3000",
            "fax_number": "605-504-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHOMVA",
        "first_name": "CHENGETAI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "12745273-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.