SETH SCHMOLL DO
NPI 1528470853
Preventive Medicine - Sports Medicine in Sioux Falls, SD

Q: What is Seth Schmoll's NPI number?

The NPI number for Seth Schmoll is 1528470853. It was assigned to this individual provider in the NPPES registry on May 21, 2014.

Q: What is Seth Schmoll's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Sports Medicine, with taxonomy code 2083S0010X.

Q: When was this NPI record last updated?

The NPPES record for Seth Schmoll was last updated on September 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 May 21, 2014PECOS EnrolledAccepts Medicare Assignment

97.08/100

CMS Quality Rating

1210 W 18TH ST STE G01, SIOUX FALLS, SD 57104(605) 328-2663 Get Directions Write a Review

NPPES record last updated: September 20, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jun 16, 2023, Jan 21, 2022, Mar 20, 2021 and 2 more (5 updates tracked since 2020).

On this page

About Seth Schmoll Do NPPES

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

SETH SCHMOLL DO (NPI 1528470853) is an individual sports medicine provider in Sioux Falls, South Dakota, licensed in South Dakota (14276) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Sanford Luverne Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1528470853

Entity TypeIndividualMale

Primary Taxonomy2083S0010X

Provider Legal NameSETH SCHMOLLCredential: DO

Location Address1210 W 18TH ST STE G01Sioux Falls, SD 57104-4651

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074

Phone(605) 328-2663

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateMay 21, 2014

Last NPPES UpdateSeptember 20, 20235 updates tracked since enumeration

NPPES CertifiedSeptember 20, 2023

✔ NPI 1528470853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPreventive Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2083S0010X

License✔ Licensed in SD · 14276

Definition

A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 02004796A (IN)

Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X · License 02004796A (IN), 14276 (SD)

1210 W 18TH ST STE G01, Sioux Falls, SD 57104

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Secondary Practice Locations 2

Location 11001 N Madison AveGreenwood, IN 46142-4135 · Phone (317) 528-7500 · Fax (317) 528-7515

Location 210122 E 10th St, Suite 100Indianapolis, IN 46229-2663 · Phone (317) 355-5717 · Fax (317) 355-3760

Other Identifiers 1

Medicaid201231230IN

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

Seth Schmoll Do 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 ID3678794294

PECOS Enrollment IDI20230707001855

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 6

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.

100 services70 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

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.

92 services92 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

75 services62 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

45 services45 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

35 services31 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.

14 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Sanford Luverne Medical Center

Critical Access Hospitals · Luverne, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number241371

Location1600 N Kniss AvenueLuverne, MN 56156 · Rock 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

Sioux Falls Specialty Hospital

Acute Care Hospitals · Sioux Falls, SD

OwnershipProprietary

CMS Certification Number430090

Location910 East 20th StreetSioux Falls, SD 57105 · Minnehaha County

Sanford Canton-Inwood Medical Center - Cah

Critical Access Hospitals · Canton, SD

OwnershipVoluntary non-profit - Private

CMS Certification Number431333

Location440 North Hiawatha DriveCanton, SD 57013 · Lincoln County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57104 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.

97.08/100

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

Scored through an Alternative Payment Model

Quality

86.1

Promoting Interoperability

Improvement Activities

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.

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