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

Q: 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.

Q: What is Thomas Waterbury's specialty?

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

Q: 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.

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: October 25, 2026.

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

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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

Phone(605) 977-5000

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

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Secondary Practice Location 1

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Oscar Health, Oscar Insurance Company 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

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 IDI20131007001267, I20191031001262

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 Thomas Waterbury reassigns Medicare billing to 10 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Heart Hospital Of South Dakota LLC

Same address

Cardiovascular Disease

4520 W 69TH ST
Sioux Falls, SD 57108

Reassigned Medicare billing, Iowa, Minnesota and South Dakota enrollments
34 clinicians in this Medicare group

NPI 1407109705 (605) 977-5000

Avera Mckennan

0.1 mi

Emergency Medicine

4500 W 69TH ST
Sioux Falls, SD 57108

Reassigned Medicare billing, South Dakota enrollment
1,277 clinicians in this Medicare group

NPI 1013350891 (605) 322-9777

Freeman Regional Health Services

24 mi

Rural Health

307 E STATE ST
Marion, SD 57043

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

NPI 1740570076 (605) 648-3559

Hawarden Regional Healthcare Clinics LLC

37 mi

Rural Health

1122 12TH ST
Hawarden, IA 51023

Reassigned Medicare billing, Iowa enrollment
40 clinicians in this Medicare group

NPI 1013955004 (712) 551-3400

Hawarden Regional Healthcare

37 mi

Critical Access

1111 11TH ST
Hawarden, IA 51023

Reassigned Medicare billing, Iowa enrollment
37 clinicians in this Medicare group

NPI 1841261104 (712) 551-3100

Spencer Municipal Hospital

70 mi

Clinic/Center

231 N 8TH AVE W
Hartley, IA 51346

Reassigned Medicare billing, Iowa enrollment
176 clinicians in this Medicare group

NPI 1225767338 (712) 928-1020

Wagner Community Memorial Hospital

81 mi

Critical Access

513 3RD ST SW
Wagner, SD 57380

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

NPI 1326030974 (605) 384-3611

Avera Holy Family

98 mi

Emergency Medicine

826 N 8TH ST
Estherville, IA 51334

Reassigned Medicare billing, Iowa and South Dakota enrollments
Also billed through NPI 1083652887 (South Dakota)
33 clinicians in this Medicare group

NPI 1124056338 (712) 362-2631

Avera Gettysburg

185 mi

Internal Medicine

606 E GARFIELD AVE STE C
Gettysburg, SD 57442

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

NPI 1366091357 (605) 765-2273

Regional Health Services Of Howard County

235 mi

Critical Access

235 8TH AVE W
Cresco, IA 52136

Reassigned Medicare billing, Iowa enrollment
56 clinicians in this Medicare group

NPI 1730283326 (563) 547-2101

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 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

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.

178 services164 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.

142 services81 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

117 services106 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

105 services105 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch 92928

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

103 services80 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel 92978

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

93 services87 patients

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

85 services85 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

65 services65 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

64 services64 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.

46 services46 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

39 services36 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

32 services28 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

31 services31 patients

Heart muscle strain imaging 93356

Heart muscle strain imaging is a non-invasive test that uses sound waves to create pictures of your heart. It helps doctors evaluate how well your heart muscle is working and detect any damage or disease. This can aid in diagnosing heart conditions and guiding treatment plans.

29 services27 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

27 services27 patients

Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days 93244

A heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.

21 services21 patients

Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist 93459

This procedure involves placing a tube into your left lower heart chamber, coronary artery, and bypass graft. It's done for diagnostic purposes and is carefully reviewed by a radiologist. This helps determine the health of your heart and arteries, aiding in future treatment plans.

20 services18 patients

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

20 services20 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

19 services19 patients

Insertion of tube in coronary artery for diagnosis with review by radiologist 93454

This procedure involves placing a small tube into your coronary artery. It helps to identify any blockages or issues within the artery. A radiologist, a doctor specialized in medical imaging, will review the results to ensure accurate diagnosis.

19 services19 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.

18 services18 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, each additional vessel 92979

This procedure involves using ultrasound technology to evaluate the condition of your heart's blood vessels or graft. A radiologist reviews the images to check for any abnormalities. If additional vessels need to be examined, the process is repeated.

16 services14 patients

Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel 93571

This procedure involves using ultrasound technology to examine the first blood vessel of your heart. It helps identify any abnormalities or issues, providing crucial information for diagnosis or treatment. It's a safe, non-invasive process.

13 services13 patients

Electrocardiogram (ecg) 2-day continuous with review by health care professional 93227

An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.

11 services11 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.

KELLY J STEFFEN DO

Internal Medicine (Cardiovascular Disease)