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DR. PATRICK MARK O'BRIEN M.D.
NPI 1861615155
Orthopaedic Surgery in Sioux Falls, SD

Active since April 11, 2007PECOS EnrolledAccepts Medicare Assignment
911 E 20TH ST STE 300, SIOUX FALLS, SD 57105(605) 322-1300(605) 322-1301 Get Directions Write a Review

NPPES record last updated: October 31, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 31, 2019, May 16, 2017, Mar 31, 2016 (3 updates tracked since 2016).

About Dr. Patrick Mark O'brien M.d. NPPES

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

DR. PATRICK MARK O'BRIEN M.D. (NPI 1861615155) is an individual orthopaedic surgery provider in Sioux Falls, South Dakota, licensed in South Dakota (10105) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Avera Merrill Pioneer Hospital, and maintains a secondary practice location in Sioux Falls.

NPPES Registry Identity

NPI1861615155
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. PATRICK MARK O'BRIENCredential: M.D.
Location Address911 E 20TH ST STE 300Sioux Falls, SD 57105-1045
Mailing Address911 E. 20th St, Ste 300Sioux Falls, SD 57105-1045 · (605) 322-1300 · Fax (605) 322-1301
Phone(605) 322-1300
Fax(605) 322-1301
Sole ProprietorNo
Medical School CMSCreighton University School Of MedicineGraduated 2007
Enumeration DateApril 11, 2007
Last NPPES UpdateOctober 31, 20193 updates tracked since enumeration
✔ NPI 1861615155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses✔ Licensed in SD · 10105✔ Licensed in NC · 2014-01725
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
911 E 20TH ST STE 300, Sioux Falls, SD 57105
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Secondary Practice Location 1

Location 16100 S Louise Ave Ste 2100Sioux Falls, SD 57108-6021 · Phone (605) 504-1100

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Patrick Mark O'brien M.d. 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 ID9032344403
PECOS Enrollment IDI20161102001543, I20191014003429
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Patrick O'brien reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Avera Mckennan
Same address
Ophthalmology
911 E 20TH ST STE 101
Sioux Falls, SD 57105
  • Reassigned Medicare billing, Iowa and South Dakota enrollments
  • Also billed through NPI 1255307450 (South Dakota)
  • 71 clinicians in this Medicare group
NPI 1417246901 (605) 322-3790
Avera Marshall
56 mi
Optometrist
702 10TH ST
Worthington, MN 56187
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1568401016 (Minnesota)
  • 260 clinicians in this Medicare group
NPI 1417378555 (507) 376-5535

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
188 services23 patients
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.
169 services134 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
59 services42 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.
46 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.
39 services39 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
25 services20 patients

Hospital Affiliations CMS Care Compare 5

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

Avera Merrill Pioneer Hospital

Critical Access Hospitals · Rock Rapids, IA
OwnershipVoluntary non-profit - Private
CMS Certification Number161321
Location1100 S 10th AveRock Rapids, IA 51246 · Lyon County
Emergency services

Hegg Memorial Health Center

Critical Access Hospitals · Rock Valley, IA
OwnershipVoluntary non-profit - Private
CMS Certification Number161336
Location1202 21st AvenueRock Valley, IA 51247 · Sioux County
Emergency services

Sioux Center Health

Critical Access Hospitals · Sioux Center, IA
OwnershipVoluntary non-profit - Private
CMS Certification Number161346
Location1101 9th Street SESioux Center, IA 51250 · Sioux County
Emergency services

Unc Health Nash

Acute Care Hospitals · Rocky Mount, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340147
Location2460 Curtis Ellis DriveRocky Mount, NC 27804 · Nash County
Emergency services Birthing friendly

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 57105 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 9

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

JESSICA CLARK CNP
Nurse Practitioner
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 504-1100
JOHN H. FARYNA MD
Orthopaedic Surgery
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 504-1100
DR. JUSTIN ASHLEY KRAJCA M.D.
Orthopaedic Surgery (Orthopaedic Trauma)
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 322-1300
TIFFANY MARIE JOHNSTON CNP
Nurse Practitioner
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 322-1300
DR. KATHLYN JOAN DREXLER M.D.
Orthopaedic Surgery (Hand Surgery)
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 322-1300
JONATHAN BUCHANAN MD
Internal Medicine (Sports Medicine)
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 322-1300
TIMOTHY FAGERNESS CNP
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 504-1100
MRS. TARA ANN POE MS, ATC
Specialist/Technologist (Athletic Trainer)
911 E 20TH ST STE 300
SIOUX FALLS, SD 57105
Minnehaha County (605) 322-1300

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 Patrick O'brien's NPI number?

The NPI number for Patrick O'brien is 1861615155. It was assigned to this individual provider in the NPPES registry on April 11, 2007.

Where is Patrick O'brien located?

Patrick O'brien practices at 911 E 20th St Ste 300, Sioux Falls, SD 57105. The listed phone number is (605) 322-1300.

What is Patrick O'brien's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Patrick O'brien enrolled in Medicare?

Yes. Patrick O'brien 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.

Which organizations bill Medicare for Patrick O'brien's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Patrick O'brien reassigns Medicare benefits to 2 organizations: Avera Mckennan (Sioux Falls, SD) and Avera Marshall (Worthington, MN). Each 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 Patrick O'brien's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Patrick O'brien accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Avera Health Plans and Oscar Insurance Company and 2 other insurers list Patrick O'brien 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 Patrick O'brien affiliated with any hospitals?

According to CMS data, Patrick O'brien is affiliated with Avera Merrill Pioneer Hospital, Hegg Memorial Health Center, Sioux Center Health, Unc Health Nash and Avera Mckennan Hospital & University Health Center.

When was this NPI record last updated?

The NPPES record for Patrick O'brien was last updated on October 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.