Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Roth Stofferan

Individual provider Surgical Physician Assistant · NPI 1508437559

Ethan Roth Stofferan is a Physician Assistant in Dakota Dunes, South Dakota. Qualified in 2021, 5 years ago. Practices with Cnos PC, a 98-clinician group and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021

Practice location Address checks out

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone: (605) 217-2667
Fax: (605) 217-2900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1508437559
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 9, 2021
Last updated in NPPESJuly 9, 2021
Certification dateJuly 9, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Cnos Pc — 98 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Dakota Dunes