NPIMap

Individual provider Active NPI

Paul David Berndt, M.D.

  • Family Medicine Physician
  • Parkston, SD
National Provider Identifier
1962936856
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12083 Issued in SD
Practice address
401 W Glynn Dr
Parkston, SD 57366-9605
Phone
(605) 928-7961
Fax
(605) 928-4417
NPI assigned
Apr 18, 2017
Last updated
Aug 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12083 SD Primary

Addresses

Primary practice location

401 W Glynn Dr
Parkston, SD 57366-9605

Mailing address

401 W Glynn Dr
Parkston, SD 57366-9605
Phone (605) 928-7961

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200727000611 SD Practitioner - Family Practice 0749604577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Benedict Health CenterGroup PAC ID 4880507672, shared by 5 NPIs, 13 clinicians

Practice addresses (Care Compare)

401 W Glynn Dr
Parkston, SD 57366-9605
Phone (605) 928-7961

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12083SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Benedict Health Center Family Medicine CurrentSince Jul 8, 2020 Accepting new patients
St Benedict Health Center Family Medicine CurrentSince Jul 8, 2020 Accepting new patients
St Benedict Health Center Current Accepting new patients
Lake Andes Health Care Center, Inc. Past Accepting new patients

Locations

401 W Glynn Dr
Parkston, SD 57366
Phone (605) 928-3311

Interoperability endpoints

  • Direct secure messaging: paul.berndt@avera.sdhealthlink.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Andes Senior LivingLake Andes, SD, CCN 435097 Skilled nursing facility W-2 Managing Employee Mar 13, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1962936856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W GLYNN DR",
            "city": "PARKSTON",
            "state": "SD",
            "postal_code": "573669605",
            "telephone_number": "605-928-7961",
            "fax_number": "605-928-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W GLYNN DR",
            "city": "PARKSTON",
            "state": "SD",
            "postal_code": "573669605",
            "telephone_number": "605-928-7961",
            "fax_number": "605-928-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNDT",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkston, SD

Sources for this page

Verify at the official NPI Registry.