Individual provider Active NPI

Nicole Mourelatos

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1912483157
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12992 Issued in SD
Practice address
5019 S Western Ave Ste 200
Sioux Falls, SD 57108-5155
Phone
(605) 328-9700
NPI assigned
Jul 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL15048 ND
Family Medicine Physician 207Q00000X 12992 SD Primary

Addresses

Primary practice location

5019 S Western Ave Ste 200
Sioux Falls, SD 57108-5155

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

1201 11th Ave SW
Minot, ND 58701-4207
Phone (701) 858-6778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123000004 SD Practitioner - Family Practice 2264781673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

2601 S Ellis Rd
Sioux Falls, SD 57106-7067
Phone (605) 332-2883

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

5019 S Western Ave
Suite 200
Sioux Falls, SD 57108-5155
Phone (605) 328-9700

6110 S Minnesota Ave
Sioux Falls, SD 57108-2549
Phone (605) 328-5800

Hospital & facility affiliations

  • Sanford Home Health Home health agency, Sioux Falls, SD, CCN 437004
  • Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027
  • Sanford Vermillion Medical Center Hospital, Vermillion, SD, CCN 431336

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12992SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Family Medicine CurrentSince Nov 22, 2021 Accepting new patients
Sanford Clinic CurrentSince Mar 16, 2025 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Mar 16, 2025 Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

5019 S Western Ave
Ste 200
Sioux Falls, SD 57108
Phone (605) 328-9700

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

2601 S Ellis Rd
Sioux Falls, SD 57106
Phone (605) 312-3000

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 and National Provider Directory roles.

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1912483157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5019 S WESTERN AVE STE 200",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085155",
            "telephone_number": "605-328-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 11th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587014207",
            "country_code": "US",
            "telephone_number": "701-858-6778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOURELATOS",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL15048",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.