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DR. PHILIP DEWAIN SUNDQUIST M.D.
NPI 1053520403
Family Medicine in Chariton, IA

Active since May 22, 2007PECOS EnrolledAccepts Medicare Assignment
81.6/100
CMS Quality Rating
1030 N 7TH ST, CHARITON, IA 50049(641) 217-9115 Get Directions Write a Review

NPPES record last updated: October 21, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Philip Dewain Sundquist M.d. NPPES

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

DR. PHILIP DEWAIN SUNDQUIST M.D. (NPI 1053520403) is an individual family medicine provider in Chariton, Iowa, licensed in Iowa (37367) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Lucas County Health Center, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1053520403
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PHILIP DEWAIN SUNDQUISTCredential: M.D.
Location Address1030 N 7TH STChariton, IA 50049-1206
Mailing Address1030 N 7th St, Po Box 674Chariton, IA 50049-1206 · (641) 217-9115
Phone(641) 217-9115
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateMay 22, 2007
Last NPPES UpdateOctober 21, 2010
✔ NPI 1053520403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IA · 37367✔ Licensed in AL · 26013
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1030 N 7TH ST, Chariton, IA 50049
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Other Identifiers 4

Medicaid6400210IA
Other70228IA · Wellmark
Medicare PINI20821IA
Medicare OSCAR/certificationP00446116IA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Wellmark Health Plan of Iowa, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Philip Dewain Sundquist M.d. 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 ID4789647967
PECOS Enrollment IDI20070904000535
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Philip Sundquist reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lucas County Health Center
0.1 mi
Rural Health
1200 N 7TH ST
Chariton, IA 50049
  • Reassigned Medicare billing, Iowa enrollment
  • Also billed through NPI 1588636351 (Iowa)
  • 36 clinicians in this Medicare group
NPI 1538466842 (641) 774-8103
Knoxville Community Hospital Inc
22 mi
Emergency Medicine
1002 S LINCOLN ST
Knoxville, IA 50138
  • Reassigned Medicare billing, Iowa enrollment
  • 156 clinicians in this Medicare group
NPI 1770591661 (641) 842-2151
Madison County Memorial Hospital
43 mi
Critical Access
300 W HUTCHINGS ST
Winterset, IA 50273
  • Reassigned Medicare billing, Iowa enrollment
  • 47 clinicians in this Medicare group
NPI 1831104611 (515) 462-2373
Jefferson County Hospital
45 mi
Family Medicine
1000 WILDWOOD DR STE 1
Ottumwa, IA 52501
  • Reassigned Medicare billing, Iowa enrollment
  • Also billed through NPI 1376648329 (Iowa)
  • 79 clinicians in this Medicare group
NPI 1053284299 (641) 472-4111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
19 services14 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
16 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Lucas County Health Center

Critical Access Hospitals · Chariton, IA
OwnershipVoluntary non-profit - Other
CMS Certification Number161341
Location1200 North 7th StreetChariton, IA 50049 · Lucas County
Emergency services

Jefferson County Health Center

Critical Access Hospitals · Fairfield, IA
OwnershipGovernment - Local
CMS Certification Number161364
Location2000 S MainFairfield, IA 52556 · Jefferson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 50049 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
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.55
Promoting Interoperability100
Improvement Activities40
Cost51.12

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier11 claims11 services$8.52 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

INFINITY HEALTH
Clinic/Center (Federally Qualified Health Center (FQHC))
1030 N 7TH ST
CHARITON, IA 50049
Lucas County (641) 217-9115
JUANITA LOUISE DURHAM A.R.N.P.
Nurse Practitioner (Family)
1030 N 7TH ST
CHARITON, IA 50049
Lucas County (641) 217-9115
CIRCLE OF FRIENDS HOME MEDICAL
Durable Medical Equipment & Medical Supplies
1030 N 7TH ST
CHARITON, IA 50049
Lucas County (641) 774-2339
RED HAW FAMILY MEDICAL CENTER, PC
Family Medicine
1030 N 7TH ST
CHARITON, IA 50049
Lucas County (641) 217-9115

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Philip Sundquist's NPI number?

The NPI number for Philip Sundquist is 1053520403. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Where is Philip Sundquist located?

Philip Sundquist practices at 1030 N 7th St, Chariton, IA 50049. The listed phone number is (641) 217-9115.

What is Philip Sundquist's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Philip Sundquist enrolled in Medicare?

Yes. Philip Sundquist is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Philip Sundquist's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Philip Sundquist reassigns Medicare benefits to 4 organizations: Lucas County Health Center (Chariton, IA), Knoxville Community Hospital Inc (Knoxville, IA), Madison County Memorial Hospital (Winterset, IA) and Jefferson County Hospital (Ottumwa, IA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Philip Sundquist's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Philip Sundquist accept?

Health plans from Wellmark Health Plan of Iowa, Inc. list Philip Sundquist as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Philip Sundquist affiliated with any hospitals?

According to CMS data, Philip Sundquist is affiliated with Lucas County Health Center and Jefferson County Health Center.

When was this NPI record last updated?

The NPPES record for Philip Sundquist was last updated on October 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.