JAY R ALLISON MD
NPI 1235195041
Family Medicine in Sioux Falls, SD

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since April 21, 2006PECOS EnrolledAccepts Medicare Assignment

94/100

CMS Quality Rating

1115 E 20TH ST, SIOUX FALLS, SD 57105(605) 339-1783(605) 367-7157 Get Directions Write a Review

NPPES record last updated: January 27, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jay R Allison Md NPPES

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

JAY R ALLISON MD (NPI 1235195041) is an individual family medicine provider in Sioux Falls, South Dakota, licensed in Nebraska (20321) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Rock County Hospital, and is a graduate of University Of Nebraska College Of Medicine (1995).

NPPES Registry Identity

NPI1235195041

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJAY R ALLISONCredential: MD

Location Address1115 E 20TH STSioux Falls, SD 57105-1013

Mailing Address1115 E 20th StSioux Falls, SD 57105-1013 · (605) 339-1783 · Fax (605) 367-7157

Phone(605) 339-1783

Fax(605) 367-7157

Sole ProprietorNo

Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 1995

Enumeration DateApril 21, 2006

Last NPPES UpdateJanuary 27, 2015

✔ NPI 1235195041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NE · 20321

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1115 E 20TH ST, Sioux Falls, SD 57105

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Other Identifiers 4

Medicare UPING10125NE

Medicare PIN098792004NE

Medicaid10025621600NE

Medicare PIN080128524NE

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.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

Jay R Allison 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 ID3274519087

PECOS Enrollment IDI20050411001060, I20131231000487

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 4

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Follow-up nursing facility visit per day, typically 25 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

57 services24 patients

Follow-up hospital inpatient care per day, typically 25 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.

45 services22 patients

Follow-up nursing facility visit per day, typically 15 minutes 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

30 services21 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.

14 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Rock County Hospital

Critical Access Hospitals · Bassett, NE

OwnershipGovernment - Local

CMS Certification Number281333

Location102 East South StreetBassett, NE 68714 · Holt 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

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

Freeman Medical Center - Cah

Critical Access Hospitals · Freeman, SD

OwnershipVoluntary non-profit - Private

CMS Certification Number431313

Location510 E 8th St Post Office Box 370Freeman, SD 57029 · Hutchinson 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

$85.21 typical visit price

range $55.52 – $167.23

Typical copayment $21.30 (range $13.88 – $41.80)

Most-billed visit code 99203

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.

94/100

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

Quality

84.79

Promoting Interoperability

98.22

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 16

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

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

DME-Other DME · category DE017N

3 suppliers64 claims101 services$5.61 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

2 suppliers15 claims15 services$0.98 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

4 suppliers19 claims19 services$35.87 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

5 suppliers16 claims16 services$100.27 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

4 suppliers16 claims42 services$37.97 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers16 claims16 services$22.20 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers19 claims80 services$2.74 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers39 claims39 services$19.41 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

3 suppliers27 claims27 services$14.37 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

4 suppliers36 claims36 services$43.46 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers52 claims52 services$105.65 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

1 supplier13 claims780 services$6.32 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

1 supplier16 claims990 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

1 supplier28 claims1,658 services$0.82 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier27 claims27 services$185.73 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

1 supplier28 claims28 services$26.00 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.

DAVID A BRECHTELSBAUER MD

Family Medicine