Caleb Richard Blauwet, PA
Individual provider Active NPI Physician Assistant · Sioux Falls, SD
NPI 1902285463 · NPPES record last updated Mar 30, 2022
Key facts
- NPI
- 1902285463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4647 - Phone
- (605) 328-2663
- Fax
- (605) 328-3760
- NPI assigned
- May 29, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 25
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Avera McKennan
Practice addresses (Care Compare)
1101 9TH St SE
Sioux Center, IA 51250-2501
Phone (605) 504-1100
1200 1St Ave E
Spencer, IA 51301-4342
6100 S Louise Ave
Sioux Falls, SD 57108-6029
901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538
Hospital & facility affiliations
- Avera McKennan Hospital & University Health Center
- Sioux Center Health
- Avera Dells Area Hospital - Cah
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD, IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150911002358 | SD | Practitioner - Physician Assistant | 4385951060 | Reassigns benefits to 2 organizations |
| I20220922003125 | IA | Practitioner - Physician Assistant | 4385951060 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0980 | SD | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Clinic | Current |
Accepting new patients | |
| Sanford Clinic | Current |
Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Physician Assistant | Past | Accepting new patients |
Locations
1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164
6100 S Louise Ave
Ste 1500
Sioux Falls, SD 57108
Phone (605) 504-1100
4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000
1210 W 18th St
Ste G01
Sioux Falls, SD 57104
Phone (605) 328-1395
1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300
20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
1210 W 18TH St
Suite G01
Sioux Falls, SD 57104-4647
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cblauwet6867754@direct.sanfordhealth.org |
Other providers in Sioux Falls, SD
- Rachel Ann Blake
- Hannah Renae Blankespoor
- Karyl Deann Blaseg
- Keelan Noelle Blasius
- Carolyn Ann Blatchford
- Teresa Blauwet
- Margaret Kendall Blaylock
- Elizabeth Blears
- Adam R Bleeker
- Bonnie L. Bleeker
All providers in Sioux Falls, SD · Physician Assistant in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.