| Renal Associates Pc | |
|
357 W Tower Rd Dakota Dunes SD 57049-5018 | |
| (712) 255-7746 | |
| (712) 255-0829 |
| Full Name | Renal Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 357 W Tower Rd, Dakota Dunes, South Dakota |
| Authorized Official Name and Position | Teri Harris (OFFICE MANAGER) |
| Authorized Official Contact | 7122557746 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renal Associates Pc 357 W Tower Rd Dakota Dunes SD 57049-5018 Ph: (712) 255-7746 | Renal Associates Pc 357 W Tower Rd Dakota Dunes SD 57049-5018 Ph: (712) 255-7746 |
| NPI Number | 1821044884 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7618886789 |
|---|---|
| Medicare Enrollment ID | O20040311000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821044884 | NPI | - | NPPES |
| 098555 | Other | NEBRASKA MEDICARE PTAN | |
| S108150 | Other | SD | SOUTH DAKOTA PTAN |
| 02895 | Other | IA | WELLMARK |
| 0028951 | Medicaid | IA | |
| CI7806 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Ashar Luqman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1275742090 PECOS PAC ID: 0749458685 Enrollment ID: I20110721000062 |
| Provider Name | Jerold Clancy Erlandson |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1558571497 PECOS PAC ID: 5092986869 Enrollment ID: I20110928000037 |
| Provider Name | Qasim Mahboob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548642127 PECOS PAC ID: 3678825718 Enrollment ID: I20181017003287 |
| Provider Name | Makenzie K Kreber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508496134 PECOS PAC ID: 1355762204 Enrollment ID: I20200601000775 |
| Provider Name | Kimberly A Hokinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316652043 PECOS PAC ID: 9234594615 Enrollment ID: I20230509000450 |
| Provider Name | Euclid J St Hill |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1740703990 PECOS PAC ID: 2365805249 Enrollment ID: I20231219002536 |
| Provider Name | Aura Cambara-ochoa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558126706 PECOS PAC ID: 9537508684 Enrollment ID: I20240422002813 |
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