MIKAELA THEOBALD PA-C
NPI 1124627898
Physician Assistant in Rapid City, SD

Q: What is Mikaela Theobald's NPI number?

The NPI number for Mikaela Theobald is 1124627898. It was assigned to this individual provider in the NPPES registry on October 22, 2020.

Q: What is Mikaela Theobald's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mikaela Theobald was last updated on June 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since October 22, 2020PECOS EnrolledAccepts Medicare Assignment

353 FAIRMONT BLVD, RAPID CITY, SD 57701(605) 755-1000 Get Directions Write a Review

NPPES record last updated: June 29, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mikaela Theobald Pa-c NPPES

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

MIKAELA THEOBALD PA-C (NPI 1124627898) is an individual physician assistant in Rapid City, South Dakota and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS, is affiliated with Gordon Memorial Hospital District, and maintains a secondary practice location in Rapid City.

NPPES Registry Identity

NPI1124627898

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMIKAELA THEOBALDCredential: PA-C

Location Address353 FAIRMONT BLVDRapid City, SD 57701-7375

Mailing Address353 Fairmont BlvdRapid City, SD 57701-7375 · (605) 755-1000

Phone(605) 755-1000

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateOctober 22, 2020

Last NPPES UpdateJune 29, 2023

NPPES CertifiedJune 29, 2023

✔ NPI 1124627898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

353 FAIRMONT BLVD, Rapid City, SD 57701

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Secondary Practice Location 1

Location 1353 Fairmont BlvdRapid City, SD 57701-7375 · Phone (605) 755-1000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Medica, Oscar Insurance Company and more.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

Mikaela Theobald 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 ID7012324247

PECOS Enrollment IDI20210405002455

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 4

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.

81 services80 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

50 services35 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

17 services17 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Gordon Memorial Hospital District

Critical Access Hospitals · Gordon, NE

OwnershipGovernment - Hospital District or Authority

CMS Certification Number281358

Location300 East 8th StGordon, NE 69343 · Sheridan County

Emergency services

Monument Health Spearfish Hospital

Acute Care Hospitals · Spearfish, SD

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430048

Location1440 N Main StSpearfish, SD 57783 · Lawrence County

Emergency services

Monument Health Rapid City Hospital

Acute Care Hospitals · Rapid City, SD

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430077

Location353 Fairmont BlvdRapid City, SD 57701 · Pennington County

Emergency services Birthing friendly

Monument Health Sturgis Hospital

Critical Access Hospitals · Sturgis, SD

OwnershipVoluntary non-profit - Other

CMS Certification Number431321

Location2140 Junction AveSturgis, SD 57785 · Meade County

Emergency services

Campbell County Health

Acute Care Hospitals · Gillette, WY

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number530002

Location501 South Burma AvenueGillette, WY 82716 · Campbell County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57701 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.

Other Providers at the Same Location NPPES 20

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

MONUMENT HEALTH RAPID CITY HOSPITAL, INC.

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)