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Individual provider Active NPI

Jacob Lewis Hemenway, PAC

  • Surgical Physician Assistant
  • Rapid City, SD
National Provider Identifier
1982123725
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
7220 Mount Rushmore Rd
Rapid City, SD 57702-8754
Phone
(605) 341-1414
Fax
(605) 341-7062
NPI assigned
Sep 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

7220 Mount Rushmore Rd
Rapid City, SD 57702-8754

Mailing address

PO Box 6850
Rapid City, SD 57709-6850
Phone (605) 341-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WY, ND3 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
I20171117001962 SD Practitioner - Physician Assistant 5395001754 Reassigns benefits to 2 organizations
I20190212002913 WY Practitioner - Physician Assistant 5395001754 Reassigns benefits to 2 organizations
I20191028002169 ND Practitioner - Physician Assistant 5395001754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Surgical Hospital LLC 173 clinicians
Black Hills Orthopedic and Spine Center of Wyoming PC 11 clinicians
Black Hills Orthopedic and Spine Center Inc 73 clinicians

Practice addresses (Care Compare)

216 Anamaria Dr
Rapid City, SD 57701-7366
Phone (605) 791-7777

2201 S Douglas Hwy
Suite 120
Gillette, WY 82718-5408
Phone (800) 446-9556

4141 5TH St
Rapid City, SD 57701-6021
Phone (605) 341-1414

7220 Mount Rushmore Rd
Rapid City, SD 57702-8754
Phone (605) 737-9151

Hospital & facility affiliations

  • Black Hills Surgical Hospital LLC Hospital, Rapid City, SD, CCN 430091
  • Weston County Health Services Hospital, Newcastle, WY, CCN 531303
  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077

Merit-based Incentive Payment System (MIPS)

Final score
95.06 of 100Reported as group
Quality
99.26
Promoting interoperability
90
Improvement activities
40
Cost
92.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1119SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Organizations & group practices 8

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1982123725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6850",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577096850",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 MOUNT RUSHMORE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028754",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMENWAY",
        "first_name": "JACOB",
        "middle_name": "LEWIS",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-13",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.