Individual provider Active NPI

Jesse Robert Pechous, CRNA

  • Certified Registered Nurse Anesthetist
  • Sioux Falls, SD
National Provider Identifier
1922847417
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
149570 Issued in SD
Practice address
1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone
(605) 333-1000
NPI assigned
May 23, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 149570 SD Primary

Addresses

Primary practice location

1305 W 18TH St
Sioux Falls, SD 57105-0401

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

2533 E Meadowside Pl
Sioux Falls, SD 57108-3706
Phone (605) 660-3819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806002933 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890232011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
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

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

Hospital & facility affiliations

  • Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149570SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Single Specialty CurrentSince Jul 15, 2024 Accepting new patients

Locations

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

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

Organizations & group practices 1

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 3

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": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1922847417",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-333-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2533 E Meadowside Pl",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571083706",
            "country_code": "US",
            "telephone_number": "605-660-3819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECHOUS",
        "first_name": "JESSE",
        "middle_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-07-30",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "149570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.