AMY L. NELSON MD
NPI 1407856289
Family Medicine in Sioux Falls, SD

Active since July 22, 2005PECOS EnrolledAccepts Medicare Assignment
76.69/100
CMS Quality Rating
6110 S MINNESOTA AVE, SIOUX FALLS, SD 57108(605) 328-5800(605) 328-5814 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Amy L. Nelson Md NPPES

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

AMY L. NELSON MD (NPI 1407856289) is an individual family medicine provider in Sioux Falls, South Dakota, licensed in South Dakota (5233) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS, is affiliated with Sanford Usd Medical Center, and is a graduate of Sanford School Of Medicine Of University Of South Dakota (2000).

NPPES Registry Identity

NPI1407856289
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameAMY L. NELSONCredential: MD
Location Address6110 S MINNESOTA AVESioux Falls, SD 57108-2549
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-9556 · Fax (605) 328-9501
Fax(605) 328-5814
Sole ProprietorNo
Medical School CMSSanford School Of Medicine Of University Of South DakotaGraduated 2000
Enumeration DateJuly 22, 2005
Last NPPES UpdateMarch 25, 2022
NPPES CertifiedMarch 25, 2022
NPI 1407856289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in SD · 5233
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.
6110 S MINNESOTA AVE, Sioux Falls, SD 57108

Other Identifiers 1

Medicaid5611480SD

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

Amy L. Nelson 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 ID5294756292
PECOS Enrollment IDI20051216000610
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 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
130 services89 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.
114 services79 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
74 services74 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
18 services15 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 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
$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.

76.69/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.56
Promoting Interoperability99
Improvement Activities40
Cost44.56

Referred Medical Equipment & Supplies CMS DME claims 3

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
11 suppliers19 claims32 services$6.41 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
2 suppliers13 claims13 services$14.78 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers15 claims15 services$41.30 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.

Nurse Practitioner (Family)
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108
Family Medicine
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108
Family Medicine
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108
Family Medicine
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108
Family Medicine
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108
Nurse Practitioner (Family)
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108
Nurse Practitioner (Family)
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108
Nurse Practitioner (Psychiatric/Mental Health)
6110 S MINNESOTA AVE
SIOUX FALLS, SD 57108

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 Amy Nelson's NPI number?

The NPI number for Amy Nelson is 1407856289. It was assigned to this individual provider in the NPPES registry on July 22, 2005.

Where is Amy Nelson located?

Amy Nelson practices at 6110 S Minnesota Ave, Sioux Falls, SD 57108. The listed phone number is (605) 328-5800.

What is Amy Nelson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Amy Nelson enrolled in Medicare?

Yes. Amy Nelson 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 Amy Nelson accept?

Health plans from Medica, Sanford Health Plan and Security Health Plan list Amy Nelson 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 Amy Nelson affiliated with any hospitals?

According to CMS data, Amy Nelson is affiliated with Sanford Usd Medical Center.

When was this NPI record last updated?

The NPPES record for Amy Nelson was last updated on March 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.