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TONYA D BUCHHOLZ CNP
NPI 1538311352
Nurse Practitioner in Madison, SD

Active since October 13, 2008PECOS EnrolledAccepts Medicare Assignment
323 SW 10TH STREET, MADISON, SD 57042(605) 256-6551(605) 256-6469 Get Directions Write a Review

NPPES record last updated: January 10, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 10, 2019, Dec 21, 2015 (2 updates tracked since 2015).

About Tonya D Buchholz Cnp NPPES

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

TONYA D BUCHHOLZ CNP (NPI 1538311352) is an individual nurse practitioner in Madison, South Dakota, licensed in South Dakota (CP000546) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS, is affiliated with Brookings Health System, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1538311352
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameTONYA D BUCHHOLZCredential: CNP
Location Address323 SW 10TH STREETMadison, SD 57042-3200
Mailing Address323 Sw 10th StreetMadison, SD 57042-3200 · (605) 256-6551 · Fax (605) 256-6469
Phone(605) 256-6551
Fax(605) 256-6469
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateOctober 13, 2008
Last NPPES UpdateJanuary 10, 20192 updates tracked since enumeration
✔ NPI 1538311352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in SD · CP000546
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
323 SW 10TH STREET, Madison, SD 57042
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Other Names 1

Former Name (1)Tonya D Froehlich Cnp

Other Identifiers 2

Medicaid6831610SD
OtherP00664632SD · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company, Sanford Health Plan, Wellmark of South Dakota, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tonya D Buchholz Cnp 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 ID5799847208
PECOS Enrollment IDI20081217000460, I20091029000066
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Tonya Buchholz reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Avera Queen Of Peace
20 mi
Rural Health
213 SOUTH MAIN
Howard, SD 55734
  • Reassigned Medicare billing, South Dakota enrollment
  • 227 clinicians in this Medicare group
NPI 1770817215 (605) 772-4426
City Of Brookings
25 mi
Rural Health
210 KASAN AVE
Volga, SD 57071
  • Reassigned Medicare billing, South Dakota enrollment
  • 156 clinicians in this Medicare group
NPI 1811318074 (605) 627-5701
Rural Health Care, Inc
28 mi
Federally Qualified Health Center (FQHC)
400 22ND AVE STE 1
Brookings, SD 57006
  • Reassigned Medicare billing, South Dakota enrollment
  • 111 clinicians in this Medicare group
NPI 1386254191 (605) 697-9500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Brookings Health System

Acute Care Hospitals · Brookings, SD
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number430008
Location300 22nd AveBrookings, SD 57006 · Brookings County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57042 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.

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 Tonya Buchholz's NPI number?

The NPI number for Tonya Buchholz is 1538311352. It was assigned to this individual provider in the NPPES registry on October 13, 2008. The provider is also known as Tonya D Froehlich Cnp.

Where is Tonya Buchholz located?

Tonya Buchholz practices at 323 SW 10th Street, Madison, SD 57042. The listed phone number is (605) 256-6551.

What is Tonya Buchholz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Tonya Buchholz enrolled in Medicare?

Yes. Tonya Buchholz 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.

Which organizations bill Medicare for Tonya Buchholz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tonya Buchholz reassigns Medicare benefits to 3 organizations: Avera Queen Of Peace (Howard, SD), City Of Brookings (Volga, SD) and Rural Health Care, Inc (Brookings, SD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tonya Buchholz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tonya Buchholz accept?

Health plans from Oscar Insurance Company, Sanford Health Plan and Wellmark of South Dakota, Inc. list Tonya Buchholz 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 Tonya Buchholz affiliated with any hospitals?

According to CMS data, Tonya Buchholz is affiliated with Brookings Health System.

When was this NPI record last updated?

The NPPES record for Tonya Buchholz was last updated on January 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.