Jered Marc Mancell, D.O.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

9230 Issued in SD

Practice address

401 9TH Ave NW
Watertown, SD 57201-1548

Phone

(605) 882-7000

NPI assigned

Jun 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Otolaryngology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prairie Lakes Health Care System IncGroup PAC ID 8628987823, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005

Merit-based Incentive Payment System (MIPS)

Final score

94.59 of 100Reported as group

Quality

100

Promoting interoperability

96

Improvement activities

40

Cost

85.3

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Prairie Lakes Health Care System Inc

  • Rural Acute Care Hospital
  • Watertown, SD
  • NPI 1720166002
  Medicare reassignment Care Compare group NPD
• Prairie Lakes Health Care System Inc

  • Family Medicine Physician
  • Castlewood, SD
  • NPI 1578369070
  NPD

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1942437140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCELL",
        "first_name": "JERED",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": "5101018298",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "SD",
            "license": "9230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd D Mack, CSW-PIP
• Brittany Elaine Macks
• Teresa Ann Madsen, CCSC II BS ALLIED
• Melissa J Magstadt, CNP
• Gertrude Boitumelo Makgabenyana, MA CLINICAL MENTAL
• Mark Bontreger Inc
• Dana Martens, LCSW
• Justin James Martinson, PA-C
• Marveldo LLC
• Marveldo LLC

• Facial Plastic Surgery Physician in Watertown, SD
• Providers in Watertown, SD by specialty
• Facial Plastic Surgery Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.