DR. HEATHER ELIZABETH MCDOUGALL MD
NPI 1396840401
Internal Medicine - Gastroenterology in Sioux Falls, SD

Active since September 13, 2006PECOS EnrolledAccepts Medicare Assignment
77.99/100
CMS Quality Rating
1205 S GRANGE AVE, SUITE 104, SIOUX FALLS, SD 57105(605) 328-8500(605) 328-8501 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Heather Elizabeth Mcdougall Md NPPES

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

DR. HEATHER ELIZABETH MCDOUGALL MD (NPI 1396840401) is an individual gastroenterology provider in Sioux Falls, South Dakota, licensed in South Dakota (8199) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Sanford Usd Medical Center, and is a graduate of Indiana University School Of Medicine (2001).

NPPES Registry Identity

NPI1396840401
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameDR. HEATHER ELIZABETH MCDOUGALLCredential: MD
Location Address1205 S GRANGE AVE, SUITE 104Sioux Falls, SD 57105-0407
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-6585 · Fax (605) 328-6512
Fax(605) 328-8501
Sole ProprietorYes
Medical School CMSIndiana University School Of MedicineGraduated 2001
Enumeration DateSeptember 13, 2006
Last NPPES UpdateMarch 25, 2022
NPPES CertifiedMarch 25, 2022
NPI 1396840401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in SD · 8199
Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 47238 (MN)
1205 S GRANGE AVE, Sioux Falls, SD 57105

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

Dr. Heather Elizabeth Mcdougall 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 ID6507032976
PECOS Enrollment IDI20120106000134
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 7

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.

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.
68 services65 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
49 services49 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
35 services34 patients
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235
This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.
31 services30 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
28 services28 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
19 services19 patients

Hospital Affiliations CMS Care Compare

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

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

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
Quality80.13
Promoting Interoperability99
Improvement Activities40
Cost47.35

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.

Nurse Practitioner (Family)
1205 S GRANGE AVE
SIOUX FALLS, SD 57105
Pediatrics
1205 S GRANGE AVE, SUITE 307
SIOUX FALLS, SD 57105
Pediatrics
1205 S GRANGE AVE, STE 307
SIOUX FALLS, SD 57105
Internal Medicine (Nephrology)
1205 S GRANGE AVE, SUITE 201
SIOUX FALLS, SD 57105
Internal Medicine
1205 S GRANGE AVE, STE 510
SIOUX FALLS, SD 57105
Social Worker
1205 S GRANGE AVE, SUITE 510
SIOUX FALLS, SD 57105
Internal Medicine (Nephrology)
1205 S GRANGE AVE, SUITE 201
SIOUX FALLS, SD 57105
Internal Medicine
1205 S GRANGE AVE, STE 510
SIOUX FALLS, SD 57105

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 Heather Mcdougall's NPI number?

The NPI number for Heather Mcdougall is 1396840401. It was assigned to this individual provider in the NPPES registry on September 13, 2006.

Where is Heather Mcdougall located?

Heather Mcdougall practices at 1205 S Grange Ave Suite 104, Sioux Falls, SD 57105. The listed phone number is (605) 328-8500.

What is Heather Mcdougall's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Heather Mcdougall enrolled in Medicare?

Yes. Heather Mcdougall 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 Heather Mcdougall accept?

Health plans from Medica, Sanford Health Plan and Security Health Plan list Heather Mcdougall 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 Heather Mcdougall affiliated with any hospitals?

According to CMS data, Heather Mcdougall is affiliated with Sanford Usd Medical Center.

When was this NPI record last updated?

The NPPES record for Heather Mcdougall was last updated on March 25, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.