Individual provider Active NPI

Ananta Subedi, M.D.

  • Internal Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1962886929
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11011 Issued in SD
Practice address
1325 S Cliff Ave
Sioux Falls, SD 57105
Phone
(605) 322-7905
NPI assigned
Jul 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11011 SD Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1325 S Cliff Ave
Sioux Falls, SD 57105

Mailing address

1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 322-7905

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
I20180821003064 SD Practitioner - Internal Medicine 9436408614 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Jul 31, 2018 Accepting new patients

Locations

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1437264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1962886929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-322-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57105",
            "telephone_number": "605-322-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBEDI",
        "first_name": "ANANTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-19",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "11011",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.