DR. ANTHONY PAUL WHITLOW D.O.
NPI 1386179570
Hospitalist in Sioux Falls, SD

Q: What is Anthony Whitlow's NPI number?

The NPI number for Anthony Whitlow is 1386179570. It was assigned to this individual provider in the NPPES registry on April 25, 2017.

Q: What is Anthony Whitlow's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Whitlow was last updated on October 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 25, 2017PECOS EnrolledAccepts Medicare Assignment

77.99/100

CMS Quality Rating

1305 W 18TH ST, SIOUX FALLS, SD 57105(605) 328-4973(605) 328-1295 Get Directions Write a Review

NPPES record last updated: October 19, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 19, 2020, Apr 28, 2017 (2 updates tracked since 2017).

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About Dr. Anthony Paul Whitlow D.o. NPPES

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

DR. ANTHONY PAUL WHITLOW D.O. (NPI 1386179570) is an individual hospitalist provider in Sioux Falls, South Dakota, licensed in South Dakota (12048) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Windom Area Health, and is a graduate of Lincoln Memorial University Medical Department (2017).

NPPES Registry Identity

NPI1386179570

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameDR. ANTHONY PAUL WHITLOWCredential: D.O.

Location Address1305 W 18TH STSioux Falls, SD 57105-0401

Mailing Address1305 W 18th StSioux Falls, SD 57105-0401 · (605) 328-4973 · Fax (605) 328-1295

Phone(605) 328-4973

Fax(605) 328-1295

Sole ProprietorNo

Medical School CMSLincoln Memorial University Medical DepartmentGraduated 2017

Enumeration DateApril 25, 2017

Last NPPES UpdateOctober 19, 20202 updates tracked since enumeration

NPPES CertifiedOctober 19, 2020

✔ NPI 1386179570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in SD · 12048

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1305 W 18TH ST, Sioux Falls, SD 57105

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.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

Dr. Anthony Paul Whitlow D.o. 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 ID7416291265

PECOS Enrollment IDI20201216000000

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 5

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.

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.

245 services110 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.

241 services109 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

121 services120 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.

82 services81 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Windom Area Health

Critical Access Hospitals · Windom, MN

OwnershipGovernment - Local

CMS Certification Number241332

Location2150 Hospital Drive, PO Box 339Windom, MN 56101 · Cottonwood County

Emergency services

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

Sanford Medical Center Aberdeen

Acute Care Hospitals · Aberdeen, SD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430097

Location2905 3rd Ave SEAberdeen, SD 57402 · Brown County

Emergency services Birthing friendly

Sanford Vermillion Hospital

Critical Access Hospitals · Vermillion, SD

OwnershipVoluntary non-profit - Private

CMS Certification Number431336

Location20 South Plum StreetVermillion, SD 57069 · Clay 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

$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.

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.

77.99/100

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

Scored as part of a group practice

Quality

80.13

Promoting Interoperability

Improvement Activities

Cost

47.35

Referred Medical Equipment & Supplies CMS DME claims

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

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

5 suppliers31 claims31 services$91.02 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.

JEDD D BIALAS CRNA

Nurse Anesthetist, Certified Registered