PEDIATRIC SURGICAL ASSOCIATES PC (NPI# 1114957818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114957818 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SURGICAL ASSOCIATES PC |
| Practice Address |
1001 E 21st St Ste # 012 Sioux Falls SD 57105-1033 |
| Mailing Address |
Po Box 5126 Sioux Falls SD 57117-5126 |
| Practice Telephone | 6053227530 |
| Mailing Telephone | 6059772767 |
| Mailing Fax Number | 6053739971 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2009-09-01 |
| Authorized Official Name | STEPHEN R KARL (OWNER AND PROVIDER) |
| Authorized Official Telephone | 6053227530 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
1001 E 21ST ST STE # 012 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134191869 | Kozhikode Veetil Narayanan Menon | Internal Medicine | 1001 E 21st St, Suite 303, Sioux Falls, SD 57105-1033 | 2006-02-06 |
| 1154552412 | Trisha H Justice | Nurse Practitioner | 1001 E 21st St, Ste 010, Sioux Falls, SD 57105-1033 | 2009-08-05 |
| 1295782613 | Stephen R Karl | Surgery | 1001 E 21st St, Ste # 012, Sioux Falls, SD 57105-1033 | 2006-05-30 |
| 1437125119 | Tina M Melanson | Internal Medicine | 1001 E 21st St, Ste. 300, Sioux Falls, SD 57105-1033 | 2006-02-23 |
| 1548233885 | Avera Mckennan | Radiologic Technologist | 1001 E 21st St, Ste. 403, Sioux Falls, SD 57105-1033 | 2006-02-08 |
| 1770555245 | Patricia J Bunger | Pediatrics | 1001 E 21st St, Ste. 200, Sioux Falls, SD 57105-1033 | 2006-02-07 |
| 1619949153 | Mary K Kunde | Psychologist | 1001 E 21st St, Ste. 100, Sioux Falls, SD 57105-1033 | 2006-02-07 |
| 1356313928 | Paula K. Pardy | Obstetrics & Gynecology | 1001 E 21st St, Sioux Falls, SD 57105-1017 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437311735 | Jon Ryckman | Surgery | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2008-06-27 |
| 1295782613 | Stephen R Karl | Surgery | 1001 E 21st St, Ste # 012, Sioux Falls, SD 57105-1033 | 2006-05-30 |
| 1689644965 | Anthony James Bufo | Surgery | 1417 S. Cliff Ave., Ste. 010, Sioux Falls, SD 57105-1014 | 2006-01-26 |
| City | SIOUX FALLS |
| Zip Code | 57105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.