NPIMap

Individual provider Active NPI

Lisa Carol Amiotte, M.D.

  • Psychiatry Physician
  • Sioux Falls, SD
National Provider Identifier
1871565333
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5512 Issued in SD
Practice address
4400 W. 69TH St
Ste. 500
Sioux Falls, SD 57108-8171
Phone
(605) 322-7580
Fax
(605) 322-7579
NPI assigned
Feb 7, 2006
Last updated
Jan 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5512 SD Primary

Addresses

Primary practice location

4400 W. 69TH St
Ste. 500
Sioux Falls, SD 57108-8171

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
7101860MedicaidSD
7102820MedicaidSD

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
I20040922000956 SD Practitioner - Psychiatry 3274501796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Sanford School of Medicine of University of South Dakota, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of South DakotaGroup PAC ID 9032007679, 7 clinicians

Practice addresses (Care Compare)

3515 Broadway Ave
Yankton, SD 57078-4917
Phone (605) 668-3107

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5512SDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of South Dakota Current Accepting new patients
State of South Dakota CurrentSince Dec 10, 2007 Accepting new patients
Avera McKennan Past Accepting new patients
Southeastern Behavioral Healthcare PastSince Dec 18, 2013 Accepting new patients
Avera McKennan Psychiatry Past Accepting new patients
Southwestern Mental Health Center Inc PastSince Aug 15, 2016 Accepting new patients
Southeastern Behavioral Healthcare Past Accepting new patients

Locations

500 E Capitol Ave
#212
Pierre, SD 57501

3515 Broadway Ave
Yankton, SD 57078
Phone (605) 668-3100

Organizations & group practices 7

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1871565333",
    "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": "4400 W. 69TH ST",
            "address_2": "STE. 500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088171",
            "telephone_number": "605-322-7580",
            "fax_number": "605-322-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIOTTE",
        "first_name": "LISA",
        "middle_name": "CAROL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "5512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101860",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102820",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.