| Gregory Kent Nissen, | |
|
3801 S Elmwood Ave, Sioux Falls, SD 57105-6565 | |
| (605) 306-6140 | |
| (605) 306-6500 |
| Full Name | Gregory Kent Nissen |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 14 Years |
| Location | 3801 S Elmwood Ave, Sioux Falls, South Dakota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174813729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 10915 (South Dakota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Avera Mckennan Hospital & University Health Center | Sioux falls, SD | Hospital |
| Avera St Benedict Health Center - Cah | Parkston, SD | Hospital |
| Prairie Lakes Healthcare System, Inc | Watertown, SD | Hospital |
| Winner Regional Healthcare Center - Cah | Winner, SD | Hospital |
| Huron Regional Medical Center | Huron, SD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dakota Vascular Prof Llc | 9931588399 | 5 |
| Entity Name | Dakota Vascular Prof Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407591258 PECOS PAC ID: 9931588399 Enrollment ID: O20220615002756 |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Kent Nissen, 3801 S Elmwood Ave, Sioux Falls, SD 57105-6565 Ph: (605) 306-6100 | Gregory Kent Nissen, 3801 S Elmwood Ave, Sioux Falls, SD 57105-6565 Ph: (605) 306-6140 |
Mark Shashikant, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 6215 South Cliff Avenue, Sioux Falls, SD 57108 Phone: 605-322-4130 Fax: 605-322-4131 | |
Dennis Glatt, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1201 S Euclid Ave, Ste 104, Sioux Falls, SD 57105 Phone: 605-328-3840 Fax: 605-328-3841 | |
Bradley Clark Thaemert, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 911 E 20th St, Ste 700, Sioux Falls, SD 57105 Phone: 605-334-0393 Fax: 605-334-6028 | |
Dr. Patrick Wayne Kelly, MD Surgery Medicare: May Accept Medicare Assignments Practice Location: 3801 S Elmwood Ave, Sioux Falls, SD 57105 Phone: 605-306-6140 Fax: 605-306-6500 | |
Kirke Wheeler, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1201 S Euclid Ave, Ste 104, Sioux Falls, SD 57105 Phone: 605-328-3840 Fax: 605-328-3841 | |
Dr. Scott James Keckler, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 1600 W 22nd St, Sioux Falls, SD 57105 Phone: 605-312-1000 Fax: 605-312-1001 |