THOMAS M. WATERBURY MD
NPI 1225392160
Internal Medicine - Interventional Cardiology in Sioux Falls, SD

Active since June 26, 2012PECOS EnrolledAccepts Medicare Assignment
4520 W 69TH ST, SIOUX FALLS, SD 57108(605) 977-5000(605) 977-5377 Get Directions Write a Review

NPPES record last updated: July 10, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 10, 2019, Jul 3, 2018, May 24, 2018 (3 updates tracked since 2018).

About Thomas M. Waterbury Md NPPES

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

THOMAS M. WATERBURY MD (NPI 1225392160) is an individual interventional cardiology provider in Sioux Falls, South Dakota, licensed in South Dakota (11389) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Spencer Municipal Hospital, and maintains a secondary practice location in Rochester.

NPPES Registry Identity

NPI1225392160
Entity TypeIndividualMale
Primary Taxonomy207RI0011X
Provider Legal NameTHOMAS M. WATERBURYCredential: MD
Location Address4520 W 69TH STSioux Falls, SD 57108-8148
Mailing Address200 1st St SwRochester, MN 55905-0001 · (507) 284-2511
Fax(605) 977-5377
Sole ProprietorNo
Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 2012
Enumeration DateJune 26, 2012
Last NPPES UpdateJuly 10, 20193 updates tracked since enumeration
NPI 1225392160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
Licenses Licensed in SD · 11389 Licensed in MN · 56770
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal MedicineTaxonomy 207R00000X · License 56770 (MN)
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 56770 (MN)
4520 W 69TH ST, Sioux Falls, SD 57108

Secondary Practice Location 1

Location 1200 1st St SWRochester, MN 55905 · Phone (507) 284-2511

Accepted Insurance

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

Thomas M. Waterbury Md 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 ID2062658909
PECOS Enrollment IDI20191031001262
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.

Areas of Expertise CMS Part B claims 30

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.

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
796 services782 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
415 services370 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.
329 services329 patients
Nuclear medicine studies of heart muscle at rest and with stress and spect 78452
Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
303 services303 patients
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152
This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
263 services247 patients
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458
This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.
188 services186 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

Floyd Valley Healthcare

Critical Access Hospitals · Le Mars, IA
OwnershipGovernment - Local
CMS Certification Number161368
Location714 Lincoln St NELe Mars, IA 51031 · Plymouth County
Emergency services Birthing friendly

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

Avera Heart Hospital Of South Dakota

Acute Care Hospitals · Sioux Falls, SD
5/5 CMS rating
OwnershipProprietary
CMS Certification Number430095
Location4500 W 69th StSioux Falls, SD 57108 · Lincoln County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57108 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.

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.

Internal Medicine (Cardiovascular Disease)
4520 W 69TH ST
SIOUX FALLS, SD 57108
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4520 W 69TH ST
SIOUX FALLS, SD 57108
Internal Medicine (Cardiovascular Disease)
4520 W 69TH ST
SIOUX FALLS, SD 57108
Physician Assistant
4520 W 69TH ST
SIOUX FALLS, SD 57108
Nurse Practitioner (Family)
4520 W 69TH ST
SIOUX FALLS, SD 57108
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4520 W 69TH ST
SIOUX FALLS, SD 57108
Nurse Practitioner (Family)
4520 W 69TH ST
SIOUX FALLS, SD 57108
Internal Medicine (Cardiovascular Disease)
4520 W 69TH ST
SIOUX FALLS, SD 57108

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 Thomas Waterbury's NPI number?

The NPI number for Thomas Waterbury is 1225392160. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Where is Thomas Waterbury located?

Thomas Waterbury practices at 4520 W 69th St, Sioux Falls, SD 57108. The listed phone number is (605) 977-5000.

What is Thomas Waterbury's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Thomas Waterbury enrolled in Medicare?

Yes. Thomas Waterbury 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.

What insurance does Thomas Waterbury accept?

Health plans from Avera Health Plans, Medica, Oscar Insurance Company and Sanford Health Plan list Thomas Waterbury 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 Thomas Waterbury affiliated with any hospitals?

According to CMS data, Thomas Waterbury is affiliated with Spencer Municipal Hospital, Lakes Regional Healthcare, Floyd Valley Healthcare, Avera Mckennan Hospital & University Health Center and Avera Heart Hospital Of South Dakota.

When was this NPI record last updated?

The NPPES record for Thomas Waterbury was last updated on July 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.