DR. RANDALL SCOTT FENNER M.D.
NPI 1073780375
Internal Medicine - Endocrinology, Diabetes & Metabolism in Sioux Falls, SD

Q: What is Randall Fenner's NPI number?

The NPI number for Randall Fenner is 1073780375. It was assigned to this individual provider in the NPPES registry on May 15, 2008.

Q: What is Randall Fenner's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Randall Fenner was last updated on April 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 15, 2008PECOS EnrolledAccepts Medicare Assignment

90.18/100

CMS Quality Rating

1305 W 18TH ST, SIOUX FALLS, SD 57105(605) 328-8700 Get Directions Write a Review

NPPES record last updated: April 4, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Randall Scott Fenner M.d. NPPES

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

DR. RANDALL SCOTT FENNER M.D. (NPI 1073780375) is an individual endocrinology, diabetes & metabolism provider in Sioux Falls, South Dakota, licensed in South Dakota (8830) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Orange City Area Health System, and is a graduate of Sanford School Of Medicine Of University Of South Dakota (2008).

NPPES Registry Identity

NPI1073780375

Entity TypeIndividualMale

Primary Taxonomy207RE0101X

Provider Legal NameDR. RANDALL SCOTT FENNERCredential: M.D.

Location Address1305 W 18TH STSioux Falls, SD 57105-0401

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074

Phone(605) 328-8700

Sole ProprietorNo

Medical School CMSSanford School Of Medicine Of University Of South DakotaGraduated 2008

Enumeration DateMay 15, 2008

Last NPPES UpdateApril 4, 2022

NPPES CertifiedApril 4, 2022

✔ NPI 1073780375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

Licenses✔ Licensed in SD · 8830✔ Licensed in NH · RT2213

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1305 W 18TH ST, Sioux Falls, SD 57105

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan, Security Health Plan, Wellmark Health Plan of Iowa, Inc. and more.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. Randall Scott Fenner 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 ID9335381409

PECOS Enrollment IDI20130820000766

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

Medicare enrollment records show Randall Fenner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sanford Clinic

Same address

Anatomic Pathology & Clinical Pathology

1305 W 18TH ST
Sioux Falls, SD 57105

Reassigned Medicare billing, South Dakota enrollment
826 clinicians in this Medicare group

NPI 1043583537 (605) 333-1720

Sanford Medical Center

0.7 mi

Family Medicine

1420 W 22NDST STE 104
Sioux Falls, SD 57105

Reassigned Medicare billing, South Dakota enrollment
1,097 clinicians in this Medicare group

NPI 1093090342 (605) 328-4897

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 8

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 moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

433 services128 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

227 services158 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

86 services84 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

77 services73 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

42 services21 patients

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.

31 services19 patients

Hospital Affiliations CMS Care Compare 5

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

Orange City Area Health System

Critical Access Hospitals · Orange City, IA

OwnershipVoluntary non-profit - Other

CMS Certification Number161360

Location1000 Lincoln Circle SEOrange City, IA 51041 · Sioux County

Emergency services

Sanford Sheldon Medical Center

Critical Access Hospitals · Sheldon, IA

OwnershipVoluntary non-profit - Private

CMS Certification Number161381

Location118 North 7th AvenueSheldon, IA 51201 · Obrien County

Emergency services

Sanford Worthington Medical Center

Acute Care Hospitals · Worthington, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number240022

Location1018 Sixth Avenue PO Box 997Worthington, MN 56187 · Nobles County

Emergency services Birthing friendly

Sanford Usd Medical Center

Acute Care Hospitals · Sioux Falls, SD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430027

Location1305 W 18th St Post Office Box 5039Sioux Falls, SD 57117 · Minnehaha County

Emergency services Birthing friendly

Sanford Vermillion Hospital

Critical Access Hospitals · Vermillion, SD

OwnershipVoluntary non-profit - Private

CMS Certification Number431336

Location20 South Plum StreetVermillion, SD 57069 · Clay County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57105 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

$126.78 typical visit price

range $55.52 – $167.23

Typical copayment $31.69 (range $13.88 – $41.80)

Most-billed visit code 99204

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.

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.

90.18/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

86.69

Improvement Activities

Cost

91.67

Referred Medical Equipment & Supplies CMS DME claims 9

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

5 suppliers16 claims199 services$18.49 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

5 suppliers16 claims500 services$2.40 avg. paid by Medicare

Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238

DME-Medical/Surgical Supplies · category DA000N

2 suppliers13 claims13 services$170.68 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

20 suppliers89 claims263 services$6.39 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers13 claims27 services$1.14 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

4 suppliers13 claims26 services$56.98 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 20

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

JEDD D BIALAS CRNA

Nurse Anesthetist, Certified Registered