DR. KEVIN MARQUEZ M.D.
NPI 1205179470
Internal Medicine - Nephrology in Sioux Falls, SD

Q: What is Kevin Marquez's NPI number?

The NPI number for Kevin Marquez is 1205179470. It was assigned to this individual provider in the NPPES registry on April 5, 2013.

Q: What is Kevin Marquez's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Marquez was last updated on October 7, 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 April 05, 2013PECOS EnrolledAccepts Medicare Assignment

1315 S CLIFF AVE STE 2000, SIOUX FALLS, SD 57105(605) 322-5800(605) 322-5801 Get Directions Write a Review

NPPES record last updated: October 7, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 7, 2022, Nov 4, 2016 (2 updates tracked since 2016).

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About Dr. Kevin Marquez M.d. NPPES

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

DR. KEVIN MARQUEZ M.D. (NPI 1205179470) is an individual nephrology provider in Sioux Falls, South Dakota, licensed in South Dakota (10931) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Spencer Municipal Hospital, and is a graduate of University Of Colorado School Of Medicine, Denver (2012).

NPPES Registry Identity

NPI1205179470

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. KEVIN MARQUEZCredential: M.D.

Location Address1315 S CLIFF AVE STE 2000Sioux Falls, SD 57105-1058

Mailing Address1315 S Cliff Ave Ste 2000Sioux Falls, SD 57105-1058 · (605) 322-5800 · Fax (605) 322-5801

Phone(605) 322-5800

Fax(605) 322-5801

Sole ProprietorYes

Medical School CMSUniversity Of Colorado School Of Medicine, DenverGraduated 2012

Enumeration DateApril 5, 2013

Last NPPES UpdateOctober 7, 20222 updates tracked since enumeration

NPPES CertifiedOctober 7, 2022

✔ NPI 1205179470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

Licenses✔ Licensed in SD · 10931✔ Licensed in IA · MD-45351✔ Licensed in CA · A143474

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1315 S CLIFF AVE STE 2000, Sioux Falls, SD 57105

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware 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. Kevin Marquez 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 ID42449167

PECOS Enrollment IDI20180809005684, I20180904002927

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 Reassignment

Medicare enrollment records show Kevin Marquez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Avera Mckennan

Same address

Psychiatry

911 E 20TH ST, STE. 403
Sioux Falls, SD 57105

Reassigned Medicare billing, South Dakota and Iowa enrollments
Also billed through NPI 1417246901 (Iowa)
1,277 clinicians in this Medicare group

NPI 1609848175 (605) 322-7516

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 16

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.

Dialysis services, per day, less than full month service (20 years or older) 90970

Dialysis is a treatment that replicates some functions of healthy kidneys when they're not working properly. It helps to remove waste, salt, and excess water from your body and maintain a safe level of certain chemicals in your blood. This service, for patients aged 20 or older, is provided on a daily basis for less than a full month.

867 services28 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.

690 services463 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

273 services35 patients

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

116 services74 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

102 services23 patients

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.

101 services47 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

63 services32 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

63 services57 patients

Dialysis services, 1 physician visit per month (20 years or older) 90962

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys canâ€™t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.

35 services17 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.

33 services31 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

32 services19 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

31 services31 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

18 services16 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

17 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

15 services15 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Spencer Municipal Hospital

Acute Care Hospitals · Spencer, IA

5/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number160112

Location1200 1st Avenue EastSpencer, IA 51301 · Clay County

Emergency services Birthing friendly

Lakes Regional Healthcare

Acute Care Hospitals · Spirit Lake, IA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number160124

Location2301 Highway 71Spirit Lake, IA 51360 · Dickinson County

Emergency services Birthing friendly

Sioux Center Health

Critical Access Hospitals · Sioux Center, IA

OwnershipVoluntary non-profit - Private

CMS Certification Number161346

Location1101 9th Street SESioux Center, IA 51250 · Sioux County

Emergency services

Avera Holy Family Hospital

Critical Access Hospitals · Estherville, IA

OwnershipVoluntary non-profit - Private

CMS Certification Number161351

Location826 North 8th StreetEstherville, IA 51334 · Emmet County

Emergency services

Avera Mckennan Hospital & University Health Center

Acute Care Hospitals · Sioux Falls, SD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430016

Location1325 S Cliff AveSioux Falls, SD 57117 · Minnehaha County

Emergency services Birthing friendly

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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims1,288 services$0.32 avg. paid by Medicare

Prednisone, immediate release or delayed release, oral, 1 mg J7512

Treatment-Treatment - Miscellaneous · category RX029N

4 suppliers35 claims6,100 services$0.01 avg. paid by Medicare

Cyclosporine, oral, 25 mg J7515

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier12 claims2,160 services$0.60 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

3 suppliers21 claims21 services$18.94 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

4 suppliers51 claims55 services$12.17 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.

WYATT KNOBLOCH

Nurse Practitioner (Family)

1315 S CLIFF AVE STE 2000
SIOUX FALLS, SD 57105

Minnehaha County (605) 322-5800

HOLLY ANN LOUISE JENSEN DNP, ARNP

Nurse Practitioner (Family)

1315 S CLIFF AVE STE 2000
SIOUX FALLS, SD 57105

Minnehaha County (605) 322-5800

MISS ELIZABETH MARIE KALLSEN CNP

Nurse Practitioner (Family)

1315 S CLIFF AVE STE 2000
SIOUX FALLS, SD 57105

Minnehaha County (605) 322-5800

ERIN L GREER M.D.

Internal Medicine (Nephrology)

1315 S CLIFF AVE STE 2000
SIOUX FALLS, SD 57105

Minnehaha County (605) 322-5800

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 Kevin Marquez's NPI number?

The NPI number for Kevin Marquez is 1205179470. It was assigned to this individual provider in the NPPES registry on April 5, 2013.

Where is Kevin Marquez located?

Kevin Marquez practices at 1315 S Cliff Ave Ste 2000, Sioux Falls, SD 57105. The listed phone number is (605) 322-5800.

What is Kevin Marquez's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Kevin Marquez enrolled in Medicare?

Yes. Kevin Marquez 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 organization bills Medicare for Kevin Marquez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Marquez reassigns Medicare benefits to Avera Mckennan (Sioux Falls, SD). The 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 Kevin Marquez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Marquez accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Wellmark Health Plan of Iowa, Inc. and Wellmark of South Dakota, Inc. list Kevin Marquez 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 Kevin Marquez affiliated with any hospitals?

According to CMS data, Kevin Marquez is affiliated with Spencer Municipal Hospital, Lakes Regional Healthcare, Sioux Center Health, Avera Holy Family Hospital and Avera Mckennan Hospital & University Health Center.

When was this NPI record last updated?

The NPPES record for Kevin Marquez was last updated on October 7, 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.