MATTHEW DAVALOS
NPI 1043189277
Nurse Practitioner - Family in Rapid City, SD

Q: What is Matthew Davalos's NPI number?

The NPI number for Matthew Davalos is 1043189277. It was assigned to this individual provider in the NPPES registry on November 4, 2025.

Q: What is Matthew Davalos's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Davalos was last updated on November 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 04, 2025PECOS EnrolledAccepts Medicare Assignment

216 ANAMARIA DR, RAPID CITY, SD 57701(605) 721-4700 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Matthew Davalos NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW DAVALOS (NPI 1043189277) is an individual family provider in Rapid City, South Dakota, licensed in South Dakota (CP003907) and active in the NPI registry since November 2025. He is enrolled in Medicare PECOS, is affiliated with Black Hills Surgical Hospital Llp, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1043189277

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMATTHEW DAVALOS

Location Address216 ANAMARIA DRRapid City, SD 57701-7366

Mailing Address216 Anamaria DrRapid City, SD 57701-7366

Phone(605) 721-4700

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateNovember 4, 2025

NPPES CertifiedNovember 4, 2025

✔ NPI 1043189277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in SD · CP003907

216 ANAMARIA DR, Rapid City, SD 57701

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Matthew Davalos is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315431905

PECOS Enrollment IDI20251211000264

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Black Hills Surgical Hospital LLP

Acute Care Hospitals · Rapid City, SD

OwnershipProprietary

CMS Certification Number430091

Location216 Anamaria DrRapid City, SD 57703 · Pennington County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.21 typical visit price

range $55.52 – $167.23

Typical copayment $21.30 (range $13.88 – $41.80)

Most-billed visit code 99203

Established Patient

$97.88 typical visit price

range $18.08 – $137.08

Typical copayment $24.47 (range $4.52 – $34.27)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAILEY HEINZE

Specialist/Technologist (Athletic Trainer)