SARAH JO HEINEN MD
NPI 1538697164
Family Medicine in Rock Rapids, IA

Active since May 26, 2017PECOS EnrolledAccepts Medicare Assignment
76.69/100
CMS Quality Rating
104 BUNCOMBE DR, ROCK RAPIDS, IA 51246(712) 472-3333 Get Directions Write a Review

NPPES record last updated: May 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 27, 2022, Jun 9, 2020, Aug 28, 2019 and 1 more (4 updates tracked since 2017).

About Sarah Jo Heinen Md NPPES

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

SARAH JO HEINEN MD (NPI 1538697164) is an individual family medicine provider in Rock Rapids, Iowa, licensed in Iowa (MD-47344) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS, is affiliated with Sanford Usd Medical Center, and maintains a secondary practice location in Sioux Falls.

NPPES Registry Identity

NPI1538697164
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSARAH JO HEINENCredential: MD
Location Address104 BUNCOMBE DRRock Rapids, IA 51246-1003
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 209-8580
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 2017
Enumeration DateMay 26, 2017
Last NPPES UpdateMay 27, 20224 updates tracked since enumeration
NPPES CertifiedMay 27, 2022
NPI 1538697164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in IA · MD-47344
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.
104 BUNCOMBE DR, Rock Rapids, IA 51246

Other Names 1

Former Name (1)Sarah Abanise Md

Secondary Practice Location 1

Location 11115 E 20th StSioux Falls, SD 57105-1013 · Phone (605) 575-1644

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

Sarah Jo Heinen 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 ID7618391350
PECOS Enrollment IDI20220712002949
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 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.
139 services84 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.
61 services47 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.
32 services32 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
14 services14 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 51246 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
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
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

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
4 suppliers26 claims41 services$5.78 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 7

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

Family Medicine
104 BUNCOMBE DR
ROCK RAPIDS, IA 51246
Speech-Language Pathologist
104 BUNCOMBE DR
ROCK RAPIDS, IA 51246
Family Medicine
104 BUNCOMBE DR
ROCK RAPIDS, IA 51246
Physical Therapist
104 BUNCOMBE DR
ROCK RAPIDS, IA 51246
Occupational Therapist
104 BUNCOMBE DR
ROCK RAPIDS, IA 51246
Physician Assistant
104 BUNCOMBE DR
ROCK RAPIDS, IA 51246
Physical Therapist
104 BUNCOMBE DR
ROCK RAPIDS, IA 51246

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 Sarah Heinen's NPI number?

The NPI number for Sarah Heinen is 1538697164. It was assigned to this individual provider in the NPPES registry on May 26, 2017. The provider is also known as Sarah Abanise MD.

Where is Sarah Heinen located?

Sarah Heinen practices at 104 Buncombe Dr, Rock Rapids, IA 51246. The listed phone number is (712) 472-3333.

What is Sarah Heinen's specialty?

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

Is Sarah Heinen enrolled in Medicare?

Yes. Sarah Heinen 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 Sarah Heinen accept?

Health plans from Medica, Sanford Health Plan and Security Health Plan list Sarah Heinen 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 Sarah Heinen affiliated with any hospitals?

According to CMS data, Sarah Heinen is affiliated with Sanford Usd Medical Center.

When was this NPI record last updated?

The NPPES record for Sarah Heinen was last updated on May 27, 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.