| Dr Brent J Lindbloom, DO | |
|
100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | |
| (605) 945-5201 | |
| (605) 945-5094 |
| Full Name | Dr Brent J Lindbloom |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 100 Mac Lane, Pierre, South Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700851011 | NPI | - | NPPES |
| 6200540 | Medicaid | SD | |
| 6200543 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 1783 (South Dakota) | Secondary |
| 207V00000X | Obstetrics & Gynecology | SD1783 (South Dakota) | Primary |
| Entity Name | Avera Mckennan |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699009944 PECOS PAC ID: 0345157103 Enrollment ID: O20031110000117 |
| Entity Name | Avera St Marys |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669457180 PECOS PAC ID: 0143134965 Enrollment ID: O20040225000579 |
| Entity Name | Avera Gettysburg |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1003887266 PECOS PAC ID: 4284619362 Enrollment ID: O20061104000319 |
| Entity Name | Avera Gettysburg |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366091357 PECOS PAC ID: 4284619362 Enrollment ID: O20191025000756 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brent J Lindbloom, DO 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 Ph: (605) 945-5201 | Dr Brent J Lindbloom, DO 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 Ph: (605) 945-5201 |
Jessica Sue Rasmussen, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 100 Mac Ln, Avera Medical Associates Clinic, Pierre, SD 57501 Phone: 605-224-5901 Fax: 605-945-5295 | |
Dr. Shelley L Nielson, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 Phone: 605-945-5201 Fax: 605-945-5094 | |
Dr. Jim L Minder, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 Phone: 605-945-5201 Fax: 605-945-5094 |