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LEAH AYN MERGEN PA-C
NPI 1023389392
Physician Assistant in Sioux Falls, SD

Active since January 19, 2012PECOS EnrolledAccepts Medicare Assignment
521 N MAIN AVE STE 100, SIOUX FALLS, SD 57104(605) 367-8214 Get Directions Write a Review

NPPES record last updated: August 29, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Leah Ayn Mergen Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEAH AYN MERGEN PA-C (NPI 1023389392) is an individual physician assistant in Sioux Falls, South Dakota, licensed in South Dakota (0799) and active in the NPI registry since January 2012. She is enrolled in Medicare PECOS, is affiliated with Avera Mckennan Hospital & University Health Center, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1023389392
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLEAH AYN MERGENCredential: PA-C
Location Address521 N MAIN AVE STE 100Sioux Falls, SD 57104-5947
Mailing Address521 N Main Ave Ste 100Sioux Falls, SD 57104-5947 · (605) 367-8793
Phone(605) 367-8214
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJanuary 19, 2012
Last NPPES UpdateAugust 29, 2017
✔ NPI 1023389392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in SD · 0799
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
521 N MAIN AVE STE 100, Sioux Falls, SD 57104
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Other Identifiers 3

Medicare PINS105886SD
Medicaid6837110SD
Medicaid6837112SD

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Leah Ayn Mergen Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123289725
PECOS Enrollment IDI20120407000013
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
102 services64 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
92 services73 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
34 services34 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Avera Mckennan Hospital & University Health Center

Acute Care Hospitals · Sioux Falls, SD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430016
Location1325 S Cliff AveSioux Falls, SD 57117 · Minnehaha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.21 typical visit price
range $55.52 – $167.23
Typical copayment $21.30 (range $13.88 – $41.80)
Most-billed visit code 99203
Established Patient
$69.20 typical visit price
range $18.08 – $137.08
Typical copayment $17.30 (range $4.52 – $34.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers11 claims16 services$6.59 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CITY OF SIOUX FALLS
Community Health Worker
521 N MAIN AVE STE 100
SIOUX FALLS, SD 57104
Minnehaha County (605) 367-8029
BRITTANY MARIE LYLE
Nurse Practitioner
521 N MAIN AVE STE 100
SIOUX FALLS, SD 57104
Minnehaha County (605) 367-8793

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leah Mergen's NPI number?

The NPI number for Leah Mergen is 1023389392. It was assigned to this individual provider in the NPPES registry on January 19, 2012.

Where is Leah Mergen located?

Leah Mergen practices at 521 N Main Ave Ste 100, Sioux Falls, SD 57104. The listed phone number is (605) 367-8214.

What is Leah Mergen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Leah Mergen enrolled in Medicare?

Yes. Leah Mergen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Leah Mergen accept?

Health plans from Avera Health Plans list Leah Mergen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Leah Mergen affiliated with any hospitals?

According to CMS data, Leah Mergen is affiliated with Avera Mckennan Hospital & University Health Center.

When was this NPI record last updated?

The NPPES record for Leah Mergen was last updated on August 29, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.