| Pax Pllc | |
|
6709 S Minnesota Ave Ste 101 Sioux Falls SD 57108-2593 | |
| (605) 366-6569 | |
| Not Available |
| Full Name | Pax Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6709 S Minnesota Ave Ste 101, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Andrew Mortenson (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6053666569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pax Pllc 601 S Cliff Ave Ste 101 Sioux Falls SD 57104-5276 Ph: (605) 339-0002 | Pax Pllc 6709 S Minnesota Ave Ste 101 Sioux Falls SD 57108-2593 Ph: (605) 366-6569 |
| NPI Number | 1275353237 |
|---|---|
| Provider Enumeration Date | 10/15/2024 |
| Last Update Date | 10/15/2024 |
| Medicare PECOS PAC ID | 0840729687 |
|---|---|
| Medicare Enrollment ID | O20250123003541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275353237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Travis J Behrens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104357482 PECOS PAC ID: 8224305974 Enrollment ID: I20170530002482 |
| Provider Name | Andrew R Mortenson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811230287 PECOS PAC ID: 0244462877 Enrollment ID: I20170831002929 |
| Provider Name | Kaitlyn E Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043031495 PECOS PAC ID: 1850821604 Enrollment ID: I20250207002513 |
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