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TONYA RAE BENSON CNP
NPI 1629200639
Nurse Practitioner - Family in Estelline, SD

Active since August 10, 2009PECOS EnrolledAccepts Medicare Assignment
76.69/100
CMS Quality Rating
305 HOSPITAL DR, ESTELLINE, SD 57234(605) 873-2222(605) 873-2182 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tonya Rae Benson Cnp NPPES

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

TONYA RAE BENSON CNP (NPI 1629200639) is an individual family provider in Estelline, South Dakota, licensed in South Dakota (CP000556) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS, is affiliated with Prairie Lakes Healthcare System, Inc, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1629200639
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTONYA RAE BENSONCredential: CNP
Location Address305 HOSPITAL DREstelline, SD 57234-0196
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074
Phone(605) 873-2222
Fax(605) 873-2182
Sole ProprietorYes
Medical School CMSOtherGraduated 2009
Enumeration DateAugust 10, 2009
Last NPPES UpdateMarch 30, 2022
NPPES CertifiedMarch 30, 2022
✔ NPI 1629200639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in SD · CP000556
305 HOSPITAL DR, Estelline, SD 57234
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan, Security 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

Tonya Rae Benson 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 ID8426196866
PECOS Enrollment IDI20130318000359
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.

Hospital Affiliations CMS Care Compare 4

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

Prairie Lakes Healthcare System, Inc

Acute Care Hospitals · Watertown, SD
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430005
Location401 9th Avenue NW Post Office Box 1210Watertown, SD 57201 · Codington County
Emergency services Birthing friendly

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

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

Sanford Clear Lake Medical Center

Critical Access Hospitals · Clear Lake, SD
OwnershipVoluntary non-profit - Private
CMS Certification Number431307
Location701 Third Avenue SouthClear Lake, SD 57226 · Deuel County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57234 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 5

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
5 suppliers17 claims47 services$6.04 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
1 supplier12 claims720 services$4.67 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
1 supplier13 claims2,849 services$0.03 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
1 supplier12 claims690 services$0.82 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
1 supplier12 claims12 services$26.07 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

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

SANFORD MEDICAL CENTER
Clinic/Center (Rural Health)
305 HOSPITAL DR
ESTELLINE, SD 57234
Hamlin County (605) 873-2222

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 Benson's NPI number?

The NPI number for Tonya Benson is 1629200639. It was assigned to this individual provider in the NPPES registry on August 10, 2009.

Where is Tonya Benson located?

Tonya Benson practices at 305 Hospital Dr, Estelline, SD 57234. The listed phone number is (605) 873-2222.

What is Tonya Benson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tonya Benson enrolled in Medicare?

Yes. Tonya Benson 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 Tonya Benson accept?

Health plans from Medica, Sanford Health Plan and Security Health Plan list Tonya Benson 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 Benson affiliated with any hospitals?

According to CMS data, Tonya Benson is affiliated with Prairie Lakes Healthcare System, Inc, Brookings Health System, Sanford Usd Medical Center and Sanford Clear Lake Medical Center.

When was this NPI record last updated?

The NPPES record for Tonya Benson was last updated on March 30, 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.