Avera Queen of Peace
NPI 1053557967ActiveOrganization· Physician Assistant· De Smet, SD
Physician Assistant in De Smet, South Dakota, registered in NPPES in December 2008. The authorized official on file is Patrick J. Clark, Senior Vice President And Cfo.
Overview
| NPI | 1053557967 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 23, 2008 |
| Last updated in NPPES | Mar 1, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 0232SD | SD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Physician Assistant providers in De Smet
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