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SEAN C PFEFFER MD
NPI 1487690913
Family Medicine in Joplin, MO

Active since June 22, 2006PECOS EnrolledAccepts Medicare Assignment
90.47/100
CMS Quality Rating
3130 WISCONSIN AVE STE 6, JOPLIN, MO 64804(417) 206-9300(417) 206-9306 Get Directions Write a Review

NPPES record last updated: September 30, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 30, 2022, Feb 21, 2020 (2 updates tracked since 2020).

About Sean C Pfeffer Md NPPES

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

SEAN C PFEFFER MD (NPI 1487690913) is an individual family medicine provider in Joplin, Missouri, licensed in Missouri (2003026619) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Mercy Specialty Hospital Southeast Kansas, and is a graduate of Wayne State University School Of Medicine (1994).

NPPES Registry Identity

NPI1487690913
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSEAN C PFEFFERCredential: MD
Location Address3130 WISCONSIN AVE STE 6Joplin, MO 64804-2800
Mailing AddressPo Box 2009Joplin, MO 64803-2009 · (417) 206-9300 · Fax (417) 206-9306
Phone(417) 206-9300
Fax(417) 206-9306
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 1994
Enumeration DateJune 22, 2006
Last NPPES UpdateSeptember 30, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2022
✔ NPI 1487690913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · 2003026619
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.

3130 WISCONSIN AVE STE 6, Joplin, MO 64804
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Other Identifiers 3

OtherP00059304Rr Medicare
Medicaid209223304MO
Other183165MO · Anthem

Accepted Insurance

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

Sean C Pfeffer 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 ID1153228903
PECOS Enrollment IDI20040323000283
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.

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.
629 services286 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
433 services259 patients
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.
167 services117 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.
51 services51 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
29 services27 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
25 services25 patients

Hospital Affiliations CMS Care Compare 5

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

Mercy Specialty Hospital Southeast Kansas

Acute Care Hospitals · Galena, KS
OwnershipVoluntary non-profit - Private
CMS Certification Number170203
Location1619 K 66Galena, KS 66739 · Cherokee County

Mercy Hospital Joplin

Acute Care Hospitals · Joplin, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260001
Location100 Mercy WayJoplin, MO 64804 · Jasper County
Emergency services Birthing friendly

Freeman Health System - Freeman West

Acute Care Hospitals · Joplin, MO
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260137
Location1102 West 32nd StreetJoplin, MO 64804 · Jasper County
Emergency services Birthing friendly

Freeman Neosho Hospital

Critical Access Hospitals · Neosho, MO
OwnershipVoluntary non-profit - Private
CMS Certification Number261331
Location113 West Hickory StreetNeosho, MO 64850 · Newton County
Emergency services

Mercy Hospital Carthage

Critical Access Hospitals · Carthage, MO
OwnershipVoluntary non-profit - Private
CMS Certification Number261338
Location3125 Dr Russell Smith WayCarthage, MO 64836 · Jasper County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64804 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
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
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.

90.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities40
Cost68.24

Reported Quality Measures

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
0%286 patients5/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
100%5,561 patients5/55-star benchmark: 100%
Non-Recommended Cervical Cancer Screening in Adolescent Females
Lower rates are better for this measure.
0%21 patients
Overuse of Imaging for the Evaluation of Primary Headache
Lower rates are better for this measure.
0%136 patients
Screening for Osteoporosis for Women Aged 65-85 Years of Age
100%229 patients5/55-star benchmark: 98%
Tobacco Use and Help with Quitting Among Adolescents
93%45 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 13

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
14 suppliers83 claims179 services$6.23 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers32 claims32 services$1.03 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers16 claims16 services$93.04 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers16 claims44 services$35.62 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers15 claims15 services$19.72 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
4 suppliers20 claims20 services$15.52 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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. REILLY LUCILLE ETCHESON DNP, APRN-CNP, FNP
Nurse Practitioner
3130 WISCONSIN AVE STE 6
JOPLIN, MO 64804
Newton County (417) 206-9300
MOLLY KATHLEEN SHIFFERD MSN, RN, FNP
Nurse Practitioner (Family)
3130 WISCONSIN AVE STE 6
JOPLIN, MO 64804
Newton County (417) 206-9300

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 Sean Pfeffer's NPI number?

The NPI number for Sean Pfeffer is 1487690913. It was assigned to this individual provider in the NPPES registry on June 22, 2006.

Where is Sean Pfeffer located?

Sean Pfeffer practices at 3130 Wisconsin Ave Ste 6, Joplin, MO 64804. The listed phone number is (417) 206-9300.

What is Sean Pfeffer's specialty?

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

Is Sean Pfeffer enrolled in Medicare?

Yes. Sean Pfeffer 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 Sean Pfeffer accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 6 other insurers list Sean Pfeffer 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 Sean Pfeffer affiliated with any hospitals?

According to CMS data, Sean Pfeffer is affiliated with Mercy Specialty Hospital Southeast Kansas, Mercy Hospital Joplin, Freeman Health System - Freeman West, Freeman Neosho Hospital and Mercy Hospital Carthage.

When was this NPI record last updated?

The NPPES record for Sean Pfeffer was last updated on September 30, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.