Basic Information
| Provider Information | |||||||||
| NPI: | 1962478651 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANTELLA | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | NICHOLAS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 86370 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571186370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1315 S CLIFF AVE | ||||||||
| Address2: | STE 2000 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053225800 | ||||||||
| FaxNumber: | 6053225801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 10/16/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 3706 | SD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 57105P004 | 01 | SD | WPS TRICARE | OTHER | 6001142 | 05 | SD | MEDICAID | 0008495 | 01 | SD | BLUE CROSS | OTHER | 406751028151 | 01 | SD | PREFERRED ONE | OTHER | HP24766 | 01 | SD | HEALTHPARTNERS | OTHER | 3100121 | 01 | SD | MEDICA | OTHER | 25238 | 01 | SD | SANFORD HEALTH PLAN | OTHER | 909725200 | 05 | MN | MEDICAID | 118T7SA | 01 | MN | BLUE CROSS | OTHER | 1917534 | 05 | IA | MEDICAID | 33395 & 33394 | 01 | IA | BLUE CROSS | OTHER | 3706 | 01 | SD | DAKOTACARE | OTHER | 22864 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 390008719 | 01 | SD | RR MEDICARE | OTHER | 46022474344 | 05 | NE | MEDICAID | 118T7SA | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER | 7873 | 01 | SD | MIDLANDS CHOICE | OTHER |