AVERA ST LUKES
NPI 1174548937
Technician, Pathology in Mobridge, SD
About Avera St Lukes NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AVERA ST LUKES (NPI 1174548937), doing business as Avera St Lukes Physician Specialist Clinic, is a healthcare organization registered as a technician, pathology in Mobridge, South Dakota and active in the NPI registry since July 2006. The organization lists Ron Jacobson, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Avera St Lukes is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
258Medicare enrollment records show 258 clinicians reassign Medicare billing to Avera St Lukes, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 28
Nearest to this location (20)
See all 258Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Avera St Lukes's NPI number?
The NPI number for Avera St Lukes is 1174548937. It was assigned to this organization in the NPPES registry on July 13, 2006. The provider is doing business as Avera St Lukes Physician Specialist Clinic.
Where is Avera St Lukes located?
Avera St Lukes is located at 1400 10th Ave W, Mobridge, SD 57601. The listed phone number is (605) 845-7292.
What is Avera St Lukes's specialty?
The primary specialty registered for this NPI is Technician, Pathology with taxonomy code 246R00000X.
Is Avera St Lukes enrolled in Medicare?
Yes. Avera St Lukes is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Avera St Lukes?
According to the CMS Revalidation Reassignment List (October 2026 release), 258 clinicians in 28 Medicare specialties reassign their Medicare billing to Avera St Lukes. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (32), Internal Medicine (31) and Anesthesiology (27). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Avera St Lukes was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Avera St Lukes · NPI 1174548937
Technician, Pathology organization in Mobridge, South Dakota. Organization record, active in the CMS NPPES registry since July 13, 2006.
## Identity
- **NPI:** 1174548937 (Entity type: Organization)
- **Enumerated:** July 13, 2006
- **Primary specialty:** Technician, Pathology · taxonomy 246R00000X
- **Also known as:** Avera St Lukes Physician Specialist Clinic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Ron Jacobson, PRESIDENT
## Practice location
- **Address:** 1400 10TH AVE W, Mobridge, SD 57601-1246
- **Phone:** (605) 845-7292 · **Fax:** (605) 845-7812
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 258 clinicians in 28 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (32), Internal Medicine (31), Anesthesiology (27); 1 practice within 10 miles; [full list](https://npiprofile.com/npi/1174548937/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1174548937) · Data from the CMS NPPES public registry.