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THERESA MARIE STAMATO MD
NPI 1649225129
Pediatrics - Pediatric Cardiology in Sioux Falls, SD

Active since May 23, 2006PECOS EnrolledAccepts Medicare Assignment
76.69/100
CMS Quality Rating
1600 W 22ND ST, SIOUX FALLS, SD 57104(605) 312-1000(605) 312-1001 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 5, 2021, Dec 17, 2019 (2 updates tracked since 2019).

About Theresa Marie Stamato Md NPPES

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

THERESA MARIE STAMATO MD (NPI 1649225129) is an individual pediatric cardiology provider in Sioux Falls, South Dakota, licensed in South Dakota (4746) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Sanford Usd Medical Center, and is a graduate of State University Of Ny Upstate Medical University (1988).

NPPES Registry Identity

NPI1649225129
Entity TypeIndividualFemale
Primary Taxonomy2080P0202X
Provider Legal NameTHERESA MARIE STAMATOCredential: MD
Location Address1600 W 22ND STSioux Falls, SD 57104-1521
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-6585 · Fax (605) 328-6512
Phone(605) 312-1000
Fax(605) 312-1001
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 1988
Enumeration DateMay 23, 2006
Last NPPES UpdateAugust 5, 20212 updates tracked since enumeration
NPPES CertifiedAugust 5, 2021
✔ NPI 1649225129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in SD · 4746
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedPediatricsTaxonomy 208000000X · License 44264 (MN), 35518 (IA)
1600 W 22ND ST, Sioux Falls, SD 57104
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, HealthPartners, Oscar Insurance Company and more.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

Theresa Marie Stamato 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 ID3173504750
PECOS Enrollment IDI20040805001039
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 Theresa Stamato reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sanford Clinic
Same address
Pediatrics
1600 W 22ND ST
Sioux Falls, SD 57105
  • Reassigned Medicare billing, South Dakota enrollment
  • 826 clinicians in this Medicare group
NPI 1881610889 (605) 312-1000
Sanford Medical Center
0.8 mi
Family Medicine
1420 W 22NDST STE 104
Sioux Falls, SD 57105
  • Reassigned Medicare billing, South Dakota enrollment
  • 1,097 clinicians in this Medicare group
NPI 1093090342 (605) 328-4897
Sanford Health Network
19 mi
Family Medicine
400 N HIAWATHA DRIVE
Canton, SD 57013
  • Reassigned Medicare billing, South Dakota and Minnesota enrollments
  • Also billed through NPI 1497703045 (Minnesota)
  • 422 clinicians in this Medicare group
NPI 1033140454 (605) 987-4378

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.

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

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

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 Theresa Stamato's NPI number?

The NPI number for Theresa Stamato is 1649225129. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Theresa Stamato located?

Theresa Stamato practices at 1600 W 22nd St, Sioux Falls, SD 57104. The listed phone number is (605) 312-1000.

What is Theresa Stamato's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Theresa Stamato enrolled in Medicare?

Yes. Theresa Stamato 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 Theresa Stamato's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theresa Stamato reassigns Medicare benefits to 3 organizations: Sanford Clinic (Sioux Falls, SD), Sanford Medical Center (Sioux Falls, SD) and Sanford Health Network (Canton, 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 Theresa Stamato's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theresa Stamato accept?

Health plans from Blue Cross Blue Shield of North Dakota, HealthPartners, Oscar Insurance Company, Sanford Health Plan and Security Health Plan and 2 other insurers list Theresa Stamato 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 Theresa Stamato affiliated with any hospitals?

According to CMS data, Theresa Stamato is affiliated with Sanford Usd Medical Center.

When was this NPI record last updated?

The NPPES record for Theresa Stamato was last updated on August 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.