ALTHEA GROEN HOOYER
NPI 1154792539
Nurse Practitioner - Pediatrics in Sioux Falls, SD
NPI Status: Active since October 12, 2015
Contact Information
1600 W 22ND ST
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 312-1000
Fax: (605) 312-1001
- Individual
- Female
- Nurse Practitioner
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
About ALTHEA GROEN HOOYER
This page provides the complete NPI Profile along with additional information for Althea Groen Hooyer, a provider established in Sioux Falls, South Dakota with a medical specialization in Nurse Practitioner, focusing in pediatrics . The healthcare provider is registered in the NPI registry with number 1154792539 assigned on October 2015. The practitioner's primary taxonomy code is 363LP0200X with license number CP000984 (SD). The provider is registered as an individual and her NPI record was last updated 11 years ago.
- NPI
- 1154792539
- Provider Name
- ALTHEA GROEN HOOYER
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1600 W 22ND ST SIOUX FALLS, SD 57105
- Location Phone
- (605) 312-1000
- Location Fax
- (605) 312-1001
- Mailing Address
- PO BOX 5074 SIOUX FALLS, SD 57117
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-12-2015
- Last Update Date
- 10-12-2015
- Code Navigator
A nurse practitioner (NP) like Althea Groen Hooyer is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Pediatrics
- Taxonomy Code
- 363LP0200X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- CP000984
- License State
- SD
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - EPO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Bronze + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- ConnectPlus $0 Gold - PPO
- ConnectPlus $0 Silver - PPO
- ConnectPlus $10,600 HSA Eligible HDHP - PPO
- ConnectPlus $1800 - PPO
- ConnectPlus $4500 - PPO
- ConnectPlus $6500 HSA Eligible HDHP - PPO
- ConnectPlus $7500 HSA Eligible HDHP - PPO
- ConnectPlus MyWeighForward $2000 - PPO
- ConnectPlus MyWeighForward $6000 - PPO
- ConnectPlus Standard $2000 - PPO
- Elevate by Medica Bronze $0 Copay PCP Visits - EPO
- Elevate by Medica Bronze Premier - EPO
- Elevate by Medica Bronze Share - EPO
- Elevate by Medica Expanded Bronze Standard - EPO
- Elevate by Medica Gold $0 Copay PCP Visits - EPO
- Elevate by Medica Gold Share - EPO
- Elevate by Medica Gold Standard - EPO
- Elevate by Medica Silver $0 Copay PCP Visits - EPO
- Elevate by Medica Silver Share - EPO
- Elevate by Medica Silver Standard - EPO
- Bronze Classic - EPO
- Bronze Classic | with Bryan Health - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | with Bryan Health - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
- Bronze Simple Diabetes - EPO
- Bronze Simple Diabetes | with Bryan Health - EPO
- Gold Classic Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Althea Groen Hooyer is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 57105 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.21
- Minimum New Patient Price $55.52
- Maximum New Patient Price $167.23
- Average New Patient Copayment $21.3
- Minimum New Patient Copayment $13.88
- Maximum New Patient Copayment $41.8
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.88
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $137.08
- Average Established Patient Copayment $24.47
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.27
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1154792539, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154792539, enumerated as an "individual" on October 12, 2015.
The provider is located at 1600 W 22ND ST SIOUX FALLS, SD 57105 and the phone number is (605) 312-1000.
Nurse Practitioner with taxonomy code 363LP0200X and a focus in Pediatrics.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.
