Jon Vander Maten, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0052 Issued in SD

Practice address

100 Mac Lane
Pierre, SD 57501-0758

Phone

(605) 224-5901

Fax

(605) 945-9295

NPI assigned

Jun 16, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Avera St Marys

  dba Avera St Marys Hospital ER CRNA

  • Emergency Medicine Physician
  • Pierre, SD
  • NPI 1073305496
  NPD
• Avera St. Mary's

  dba Avera Therapy

  • Physical Therapist
  • Pierre, SD
  • NPI 1972082683
  NPD

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1851335905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575010758",
            "telephone_number": "605-224-5901",
            "fax_number": "605-945-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575010758",
            "telephone_number": "605-224-5901",
            "fax_number": "605-945-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER MATEN",
        "first_name": "JON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Umiker, DMD
• Aimee Van Houten, M.A. CCC-SLP
• Van R Inc (Medicine Shoppe)
• Louis J Van Roekel, RBG PHA (R.PH)
• Shaun D Van Roekel, APRN
• Vilas Long Term Care Pharmacy
• Vilas Long Term Care Pharmacy
• Vilas Pharmacy
• Joseph Simon Villa, MD
• Danielle Diann Vis

• Physician Assistant in Pierre, SD
• Providers in Pierre, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.