MIKAELA A PENAREDONDO PA-C NPI 1346589876

NPI Information

NPI: 1346589876
Provider Name: MIKAELA A PENAREDONDO, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
6100 S LOUISE AVE
SIOUX FALLS, SD
ZIP 57108
Phone: (605) 504-1000
Get Directions

Mikaela A Penaredondo, PA-C is a medical physician assistant in Sioux Falls, SD with 12 years of experience. Mikaela A Penaredondo, PA-C NPI is 1346589876. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduation Year:2012

The provider's business location address is:

6100 S LOUISE AVE
SIOUX FALLS, SD
ZIP 57108-029
Phone: (605) 504-1000

The NPI 1346589876 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/4/2013 and was last updated on 1/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	1709	NEBRASKA	No
2	363AM0700X	Physician Assistant	Medical	2069	MINNESOTA	No
3	363AM0700X	Physician Assistant	Medical	11579	MINNESOTA	No
4	363AM0700X	Physician Assistant	Medical	1417	SOUTH DAKOTA	Yes
5	363A00000X	Physician Assistant		11579	MINNESOTA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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