ABERDEEN INTERNAL MEDICINE
NPI 1477750289
Internal Medicine in Aberdeen, SD

Q: What is Avera St. Luke's's NPI number?

The NPI number for Avera St. Luke's is 1477750289. It was assigned to this organization in the NPPES registry on June 27, 2007. The provider is doing business as Aberdeen Internal Medicine.

Q: What is Avera St. Luke's's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Avera St. Luke's was last updated on June 30, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 June 27, 2007

201 S LLOYD ST, SUITE W270, ABERDEEN, SD 57401(605) 225-4070(605) 725-2416 Get Directions Write a Review

NPPES record last updated: June 30, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Aberdeen Internal Medicine NPPES

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

ABERDEEN INTERNAL MEDICINE (NPI 1477750289) is a healthcare organization registered as an internal medicine in Aberdeen, South Dakota and active in the NPI registry since June 2007. The organization lists Ron L Jacobson, President & Ceo, as its authorized official.

NPPES Registry Identity

NPI1477750289

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameAVERA ST. LUKE'S

Location Address201 S LLOYD ST, SUITE W270Aberdeen, SD 57401-4552

Mailing AddressPo Box 1460Aberdeen, SD 57402-1460 · (605) 225-4070 · Fax (605) 725-2416

Phone(605) 225-4070

Fax(605) 725-2416

Organization SubpartNo

Authorized OfficialRon L JacobsonPresident & Ceo · (605) 622-5125

Enumeration DateJune 27, 2007

Last NPPES UpdateJune 30, 2011

✔ NPI 1477750289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in SD · 10525

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

201 S LLOYD ST, Aberdeen, SD 57401

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Other Names 1

Doing Business AsAberdeen Internal Medicine

Other Identifiers 4

Medicare PINCG5835SD

Other9251433SD · Dakotacare

Medicare PINS101808SD

Medicaid14389ND

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Aberdeen Internal Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

258

Medicare enrollment records show 258 clinicians reassign Medicare billing to Aberdeen Internal Medicine, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 106 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 28

Nurse Practitioner32

Internal Medicine31

Anesthesiology27

Certified Registered Nurse Anesthetist (CRNA)25

Physical Therapist in Private Practice18

Family Practice15

Orthopedic Surgery13

Pathology12

20 other specialties85

Nearest to this location (20)

See all 258

Angela Mackner, FNP-C

Nurse Practitioner

NPI 1275058216

201 S LLOYD ST STE W190
Aberdeen, SD 57401

(605) 225-0025

✔ PECOS✔ Accepts MedicareSame address

Tiffany Bruckner, CNP

Nurse Practitioner

NPI 1801201439

201 S LLOYD ST STE E201
Aberdeen, SD 57401

(605) 622-2545

✔ PECOS✔ Accepts MedicareSame address

Michele Thorpe, APRN, PMHNP

Nurse Practitioner

NPI 1285328039

201 S LLOYD ST STE E201
Aberdeen, SD 57401

(605) 622-2545

✔ PECOS✔ Accepts MedicareSame address

Tage Born, MD

Obstetrics/Gynecology

NPI 1063596245

310 S PENN ST SUITE 204
Aberdeen, SD 57401

(605) 225-1636

✔ PECOS✔ Accepts Medicare0.1 mi

Richard Conklin, MD

Hematology/Oncology

NPI 1851394662

310 S PENN ST SUITE 105
Aberdeen, SD 57401

(605) 622-8700

✔ PECOS✔ Accepts Medicare0.1 mi

Kristine Fastenau, NP

Nurse Practitioner

NPI 1083354393

310 S PENN ST STE 203
Aberdeen, SD 57401

(605) 225-7326

✔ PECOS✔ Accepts Medicare0.1 mi

George Kiser, MD

Urology

NPI 1316935638

310 S PENN ST STE 202
Aberdeen, SD 57401

(605) 225-7326

✔ PECOS0.1 mi

Christopher Larson

General Surgery

NPI 1295990141

310 S PENN ST SUITE 201
Aberdeen, SD 57401

(605) 229-1367

✔ PECOS✔ Accepts Medicare0.1 mi

Chad Stapp, DPM

Podiatry

NPI 1952438996

310 S PENN ST STE 203
Aberdeen, SD 57401

(605) 622-2570

✔ PECOS✔ Accepts Medicare0.1 mi

Susheel Gundewar, M.D.

Cardiovascular Disease (Cardiology)

NPI 1639364581

310 S PENN ST STE 203
Aberdeen, SD 57401

(605) 622-2573

✔ PECOS✔ Accepts Medicare0.1 mi

Ryan Gnesda, D.O.

Interventional Radiology

NPI 1437425733

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5540

✔ PECOS0.1 mi

Anne Falken, SLP

Qualified Speech Language Pathologist

NPI 1063664829

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5000

✔ Accepts Medicare0.1 mi

Bari Fritz, MD

Pathology

NPI 1063715449

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5000

✔ PECOS✔ Accepts Medicare0.1 mi

Jason Gauer, PT

Physical Therapist in Private Practice

NPI 1003068941

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5000

✔ Accepts Medicare0.1 mi

Lawrence Donley, MD

Emergency Medicine

NPI 1982753489

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5100

✔ PECOS✔ Accepts Medicare0.1 mi

Alex Falk, MD

Family Practice

NPI 1366438814

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5100

✔ PECOS✔ Accepts Medicare0.1 mi

Nona Gab, CRNA

Certified Registered Nurse Anesthetist (CRNA)

NPI 1598848426

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5000

✔ Accepts Medicare0.1 mi

Susan Gutenkauf, OT

Occupational Therapist in Private Practice

NPI 1851771133

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5000

✔ Accepts Medicare0.1 mi

Jill Larsen, M.D.

Anesthesiology

NPI 1992036701

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5000

✔ PECOS✔ Accepts Medicare0.1 mi

Leslie Lenter, MD

Diagnostic Radiology

NPI 1245274109

305 S STATE ST
Aberdeen, SD 57401

(605) 622-5000

✔ PECOS✔ Accepts Medicare0.1 mi

See all 258 clinicians

Source: 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. Luke's's NPI number?

The NPI number for Avera St. Luke's is 1477750289. It was assigned to this organization in the NPPES registry on June 27, 2007. The provider is doing business as Aberdeen Internal Medicine.

Where is Avera St. Luke's located?

Avera St. Luke's is located at 201 S Lloyd St Suite W270, Aberdeen, SD 57401. The listed phone number is (605) 225-4070.

What is Avera St. Luke's's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Avera St. Luke's enrolled in Medicare?

Yes. Avera St. Luke's is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Avera St. Luke's?

According to the CMS Revalidation Reassignment List (October 2026 release), 258 clinicians in 28 Medicare specialties reassign their Medicare billing to Avera St. Luke's. 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, 3 practice at this address and 106 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. Luke's was last updated on June 30, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.