NPIMap

Individual provider Active NPI

J Michael Bacharach, MD

  • Cardiovascular Disease Physician
  • Sioux Falls, SD
National Provider Identifier
1972566172
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
3990 Issued in SD
Practice address
4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone
(605) 977-5000
Fax
(605) 977-5377
NPI assigned
Apr 10, 2006
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 3990 SD Primary
Vascular Surgery Physician 2086S0129X 3990 SD

Addresses

Primary practice location

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

Mailing address

4520 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-5000

Other identifiers 11

IdentifierTypeStateIssuer
931451029029OtherPREFERRED ONE
165023OtherUCARE
35693OtherHEALTH PARTNERS
3990OtherSDDAKOTACARE
03A41BAOtherMNMN BCBS - PLAN 91057NO
0970046MedicaidIA
0004040OtherSDSD BCBS
497L1BAOtherMNBCBS MN UNDER 538R2NO
6002910MedicaidSD
56195OtherIAIA BCBS #
575892100MedicaidMN

Other names 1

  • John Michael Bacharach Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN, IA3 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
I20060309000643 SD Practitioner - Peripheral Vascular DiseasePractitioner - Cardiovascular Disease (Cardiology) 3971510306 Reassigns benefits to 2 organizations
I20131113002120 MN Practitioner - Peripheral Vascular DiseasePractitioner - Cardiovascular Disease (Cardiology) 3971510306 Reassigns benefits to 1 organization
I20140118000058 IA Practitioner - Peripheral Vascular DiseasePractitioner - Cardiovascular Disease (Cardiology) 3971510306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Peripheral Vascular DiseaseAlso: Cardiovascular Disease (Cardiology)
Education
University of Wisconsin School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

916 4TH Ave SW
Pipestone, MN 56164-1890
Phone (507) 825-5811

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30879MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Hospital of South Dakota LLC CurrentSince Dec 23, 2012 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: michael.bacharach@avera.sdhealthlink.net

Organizations & group practices 3

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 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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1972566172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "BACHARACH",
        "first_name": "J",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SD",
            "license": "3990",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SD",
            "license": "3990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "931451029029",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "165023",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "35693",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "3990",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BCBS - PLAN 91057NO",
            "identifier": "03A41BA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0970046",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD BCBS",
            "identifier": "0004040",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN UNDER 538R2NO",
            "identifier": "497L1BA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002910",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA BCBS #",
            "identifier": "56195",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "575892100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "BACHARACH",
            "middle_name": "MICHAEL",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.