MOBRIDGE FAMILY PRACTICE CLINIC
NPI 1639373756
Family Medicine in Mobridge, SD
About Mobridge Family Practice Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOBRIDGE FAMILY PRACTICE CLINIC (NPI 1639373756) is a healthcare organization registered as a family medicine in Mobridge, South Dakota and active in the NPI registry since June 2007. The organization lists Ron L Jacobson, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 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)
Mobridge Family Practice Clinic 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 Mobridge Family Practice Clinic, 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. Luke's's NPI number?
The NPI number for Avera St. Luke's is 1639373756. It was assigned to this organization in the NPPES registry on June 13, 2007. The provider is doing business as Mobridge Family Practice Clinic.
Where is Avera St. Luke's located?
Avera St. Luke's is located at 1400 10th Ave W, Mobridge, SD 57601. The listed phone number is (605) 845-7292.
What is Avera St. Luke's's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
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, 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. Luke's was last updated on January 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Mobridge Family Practice Clinic · NPI 1639373756
Family Medicine organization in Mobridge, South Dakota. Organization record, active in the CMS NPPES registry since June 13, 2007.
## Identity
- **NPI:** 1639373756 (Entity type: Organization)
- **Enumerated:** June 13, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Avera St. Luke's
- **Organization subpart:** No
- **Authorized official:** Ron Jacobson, CEO
## 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/1639373756/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 18, 2008
- **Other identifiers:** Medicare PIN S6153 (SD)
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Source: [NPI Profile](https://npiprofile.com/npi/1639373756) · Data from the CMS NPPES public registry.