DR. TIMOTHY J METZ MD
NPI 1356410161
Anesthesiology - Pain Medicine in Sioux Falls, SD

NPI Status: Active since November 07, 2006

Contact Information

911 E 20TH ST STE 602
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 338-7098
Fax: (605) 335-3505

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  • Individual
  • Male
  • Years of Experience 35
  • Anesthesiology
  • Pain Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About TIMOTHY METZ

This page provides the complete NPI Profile along with additional information for Timothy Metz, a provider established in Sioux Falls, South Dakota with a medical specialization in Anesthesiology, focusing in pain medicine and more than 35 years of experience. He graduated from Sanford School Of Medicine Of University Of South Dakota in 1991. The healthcare provider is registered in the NPI registry with number 1356410161 assigned on November 2006. The practitioner's primary taxonomy code is 207LP2900X with license number 4713 (SD). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1356410161
Provider Name
DR. TIMOTHY J METZ MD
Gender
Male
Entity Type
Individual
Location Address
911 E 20TH ST STE 602 SIOUX FALLS, SD 57105
Location Phone
(605) 338-7098
Location Fax
(605) 335-3505
Mailing Address
5105 S PENNBROOK AVE SIOUX FALLS, SD 57108
Mailing Phone
(605) 338-0500
Mailing Fax
(605) 335-3505
Medical School Name
SANFORD SCHOOL OF MEDICINE OF UNIVERSITY OF SOUTH DAKOTA
Graduation Year
1991
Is Sole Proprietor?
No
Enumeration Date
11-07-2006
Last Update Date
04-18-2018
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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

Anesthesiology Pain Medicine

Taxonomy Code
207LP2900X
Type
Allopathic & Osteopathic Physicians
License No.
4713
License State
SD
Taxonomy Description
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • 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
  • ConnectPlus Standard $6000 - PPO
  • ConnectPlus Standard $7500 HSA Eligible HDHP - PPO
  • DirectConnect $0 Gold - HMO
  • DirectConnect $0 Silver - HMO
  • DirectConnect $1800 - HMO
  • DirectConnect $4500 - HMO
  • DirectConnect $6500 HSA Eligible HDHP - HMO
  • DirectConnect $7500 HSA Eligible HDHP - HMO
  • DirectConnect MyWeighForward $2000 - HMO
  • DirectConnect MyWeighForward $6000 - HMO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze HSA - EPO
  • Medica Individual Choice Bronze Share - EPO
  • Medica Individual Choice Bronze Share - HMO
  • Medica Individual Choice Expanded Bronze Standard - EPO
  • Medica Individual Choice Expanded Bronze Standard - HMO
  • Medica Individual Choice Gold $0 Copay PCP Visits - EPO
  • Medica Individual Choice Gold $0 Copay PCP Visits - HMO
  • Medica Individual Choice Gold Share - EPO
  • Medica Individual Choice Gold Share - HMO
  • Medica Individual Choice Gold Standard - EPO
  • Medica Individual Choice Gold Standard - HMO
  • Medica Individual Choice Silver $0 Copay PCP Visits - EPO
  • Medica Individual Choice Silver $0 Copay PCP Visits - HMO
  • Medica Individual Choice Silver Share - EPO
  • Medica Individual Choice Silver Share - HMO
  • Medica Individual Choice Silver Standard - EPO
  • Medica Individual Choice Silver Standard - HMO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
590007700MEDICAID (05)MN 
532754MEDICAID (05)IA 
96D03MEOTHER (01)MNBLUE CROSS MN
5700900MEDICAID (05)SD 
4997536OTHER (01)SDBLUE CROSS SD

Medicare Participation & PECOS Enrollment Status

Timothy Metz is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Timothy Metz 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

  • PECOS PAC ID: 5991834764

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20100603000996

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

This service was performed 68 times for 45 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 50 times for 46 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 17 times for 15 patients

Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician

This procedure involves a physician checking and adjusting your spinal canal drug infusion pump. The pump's programming is updated electronically and the medication reservoir is refilled, ensuring effective pain management and optimal device performance.

This service was performed 118 times for 73 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 28 times for 23 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 24 times for 24 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 67 times for 47 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 140 times for 109 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

This service was performed 35 times for 29 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 88 times for 53 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 90 times for 55 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 123 times for 106 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 38 times for 30 patients

Injection of upper or middle spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the upper or middle spine facet joint, a small joint in your back. This is done under imaging guidance for precision. It's a second-level procedure, meaning it's done on two separate joints. It can help reduce pain and inflammation.

This service was performed 17 times for 11 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 23 times for 13 patients

Insertion of spinal canal drug infusion device beneath skin

This procedure involves placing a small device under your skin that delivers medication directly into your spinal canal. It's used to manage chronic pain or spasticity. The device ensures a steady, targeted delivery of medication, potentially reducing side effects.

This service was performed 16 times for 16 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 32 times for 19 patients

New patient office or other outpatient visit, 15-29 minutes

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

This service was performed 11 times for 11 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 27 times for 27 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Timothy Metz is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER1325 S CLIFF AVE
SIOUX FALLS, SD 57117
(605) 322-8000Acute Care Hospitals

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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 1356410161, we treat the final digit (1) 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 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).

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.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
6
Unchanged
Pos 5
4
Doubled → 8
Pos 6
1
Unchanged
Pos 7
0
Doubled → 0
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
1
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 5 → 10 → 1 4 → 8 0 → 0 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 0 + 6 + 8 + 1 + 0 + 1 + 1 + 2 + 24 = 49

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 49 is 50. The difference is the calculated check digit.

50 - 49 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1356410161.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356410161, enumerated as an "individual" on November 07, 2006.

The provider is located at 911 E 20TH ST STE 602 SIOUX FALLS, SD 57105 and the phone number is (605) 338-7098.

Anesthesiology with taxonomy code 207LP2900X and a focus in Pain Medicine.

The provider might be accepting Accepts: Avera Health Plans, Medica, Medicare, Medicaid and. Please consult your insurance carrier or call the provider to verify.

Timothy Metz is affiliated with: AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER.