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Individual provider Active NPI

Bruce A Watt, MD

  • Cardiovascular Disease Physician
  • Sioux Falls, SD
National Provider Identifier
1922052075
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
1655 Issued in SD
Practice address
4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone
(605) 977-5000
Fax
(605) 977-5377
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 1655 SD
Cardiovascular Disease Physician 207RC0000X 1655 SD Primary

Addresses

Primary practice location

4520 W 69TH St
Sioux Falls, SD 57108-8148

Mailing address

PO Box 5009
Sioux Falls, SD 57117-5009
Phone (605) 977-5000

Other identifiers 12

IdentifierTypeStateIssuer
6000872MedicaidSD
4T612WAOtherMNMN BCBS - PLAN 91057NO
415088100MedicaidMN
0933036MedicaidIA
1655OtherSDDAKOTACARE
24694OtherHEALTH PARTNERS
165035OtherUCARE
931451029050OtherPREFERRED ONE
0003371OtherSDSD BCBS
25-00495OtherMEDICA SELECTCARE
53997OtherIAIA BCBS
539ROWAOtherMNMN BCBS - PLAN 538R2NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090608000359 SD Practitioner - Interventional CardiologyPractitioner - Other (Physician) 4082621115 Reassigns benefits to 6 organizations
I20100818000504 IA Practitioner - Interventional Cardiology 4082621115 Reassigns benefits to 4 organizations
I20101207000759 MN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4082621115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Creighton University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Hospital of South Dakota LLCGroup PAC ID 5799777249, 66 clinicians

Practice addresses (Care Compare)

116 E 10TH St
Suite 101
Spencer, IA 51301-4365
Phone (712) 264-3500

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 537-9007

4500 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-7000

4520 W 69TH St
Sioux Falls, SD 57108-8148

Hospital & facility affiliations

  • Avera Heart Hospital of South Dakota Hospital, Sioux Falls, SD, CCN 430095
  • Lakes Regional Healthcare Hospital, Spirit Lake, IA, CCN 160124
  • Avera de Smet Memorial Hospital - Cah Hospital, De Smet, SD, CCN 431332
  • Avera St Mary'S Hospital Hospital, Pierre, SD, CCN 430015
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1655SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 1, 2020 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital CurrentSince Mar 30, 2021 Accepting new patients
Spencer Municipal Hospital CurrentSince Mar 30, 2021 Accepting new patients
Avera McKennan CurrentSince Sep 1, 2020 Accepting new patients
Avera Holy Family CurrentSince Jul 1, 1994 Accepting new patients
Heart Hospital of South Dakota LLC Cardiovascular Disease CurrentSince Dec 23, 2012 Accepting new patients
Wagner Community Memorial Hospital CurrentSince May 14, 2022 Accepting new patients
Avera Gettysburg CurrentSince May 1, 2024 Accepting new patients
Wagner Community Memorial Hospital CurrentSince May 14, 2022 Accepting new patients
Avera Holy Family Current Accepting new patients
Regional Health Services of Howard County CurrentSince Apr 1, 2022 Accepting new patients
Wagner Community Memorial Hospital Current Accepting new patients
Avera Holy Family CurrentSince Jul 1, 1994 Accepting new patients
Avera McKennan Current Accepting new patients
Heart Hospital of South Dakota LLC CurrentSince Dec 23, 2012 Accepting new patients
Regional Health Services of Howard County CurrentSince Apr 1, 2022 Accepting new patients

Locations

235 8th Ave W
Cresco, IA 52136
Phone (319) 547-2101

926 N 8th St
Estherville, IA 51334
Phone (712) 362-3501

826 N 8th St
Estherville, IA 51334
Phone (712) 362-2631

116 E 11th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

606 E Garfield Ave
Ste C
Gettysburg, SD 57442
Phone (605) 765-2273

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

4500 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-7000

Interoperability endpoints

  • Direct secure messaging: bruce.watt@avera.sdhealthlink.net

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1922052075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5009",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175009",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088148",
            "telephone_number": "605-977-5000",
            "fax_number": "605-977-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "BRUCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "SD",
            "license": "1655",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SD",
            "license": "1655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000872",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BCBS - PLAN 91057NO",
            "identifier": "4T612WA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415088100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0933036",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "1655",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "24694",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "165035",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "931451029050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD BCBS",
            "identifier": "0003371",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA SELECTCARE",
            "identifier": "25-00495",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA BCBS",
            "identifier": "53997",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BCBS - PLAN 538R2NO",
            "identifier": "539ROWA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.