DR. JAMES P ZWACH MD
NPI 1649246422
Family Medicine in Sioux Falls, SD

Q: What is James Zwach's NPI number?

The NPI number for James Zwach is 1649246422. It was assigned to this individual provider in the NPPES registry on February 23, 2006.

Q: What is James Zwach's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for James Zwach was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 February 23, 2006PECOS Enrolled

4405 E 26TH ST, SIOUX FALLS, SD 57103(605) 328-9000 Get Directions Write a Review

NPPES record last updated: April 24, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 24, 2024, May 20, 2022 (2 updates tracked since 2022).

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About Dr. James P Zwach Md NPPES

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

DR. JAMES P ZWACH MD (NPI 1649246422) is an individual family medicine provider in Sioux Falls, South Dakota, licensed in Minnesota (42794) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Sanford Usd Medical Center, and is a graduate of University Of Minnesota Medical School (1999).

NPPES Registry Identity

NPI1649246422

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JAMES P ZWACHCredential: MD

Location Address4405 E 26TH STSioux Falls, SD 57103-4187

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-9000 · Fax (605) 312-9004

Phone(605) 328-9000

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1999

Enumeration DateFebruary 23, 2006

Last NPPES UpdateApril 24, 20242 updates tracked since enumeration

NPPES CertifiedApril 24, 2024

✔ NPI 1649246422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MN · 42794

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.

4405 E 26TH ST, Sioux Falls, SD 57103

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Other Identifiers 2

Other1649246422MN · Npi

Medicaid1649246422MN

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 (PECOS)

Dr. James P Zwach Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1052454030

PECOS Enrollment IDI20240508001557

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 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.

191 services144 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.

75 services65 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.

63 services63 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

34 services34 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 57103 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.

Referred Medical Equipment & Supplies CMS DME claims 25

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

9 suppliers44 claims120 services$6.00 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers18 claims28 services$1.05 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

7 suppliers52 claims52 services$41.80 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

6 suppliers21 claims21 services$83.44 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

5 suppliers22 claims44 services$38.25 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

3 suppliers25 claims113 services$22.88 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

2 suppliers18 claims88 services$18.59 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

5 suppliers45 claims46 services$73.52 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

8 suppliers38 claims38 services$23.36 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

7 suppliers69 claims287 services$2.61 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

3 suppliers23 claims23 services$13.01 avg. paid by Medicare

Walker, heavy duty, wheeled, rigid or folding, any type E0149

DME-Other DME · category DE000N

1 supplier12 claims12 services$8.85 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier30 claims31 services$20.61 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier12 claims13 services$14.44 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

5 suppliers66 claims67 services$47.21 avg. paid by Medicare

Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955

DME-Wheelchairs · category DD021N

1 supplier12 claims12 services$13.34 avg. paid by Medicare

Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory E1028

DME-Wheelchairs · category DD021N

1 supplier12 claims36 services$13.62 avg. paid by Medicare

Manual adult size wheelchair, includes tilt in space E1161

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$181.16 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers53 claims54 services$112.17 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

2 suppliers11 claims660 services$4.45 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

5 suppliers23 claims3,146 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

5 suppliers32 claims1,890 services$0.75 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

1 supplier12 claims12 services$13.91 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers22 claims23 services$184.99 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

8 suppliers44 claims44 services$25.17 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 20

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

BETHANY KAY ZEIGLER MD

Family Medicine

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 328-9000

SARA AYAD AHMED AL-JUBOORI MD

Student in an Organized Health Care Education/Training Program

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 328-9000

JENNIFER A. SCHRIEVER MD

Family Medicine

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 328-9000

KATIE FIEGEN FNP

Nurse Practitioner (Family)

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 332-2883

SCOTT ALAN STAUFFENECKER C-NP

Nurse Practitioner (Family)

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 332-2883

ELIZABETH B BAUER MD

Pediatrics

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 328-9080

LOUISE M PAPKA PA-C, MPAS, DFAAPA

Physician Assistant

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 332-2883

JULIA ILENE BLUE

Pediatrics

4405 E 26TH ST
SIOUX FALLS, SD 57103

Minnehaha County (605) 328-9000

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 James Zwach's NPI number?

The NPI number for James Zwach is 1649246422. It was assigned to this individual provider in the NPPES registry on February 23, 2006.

Where is James Zwach located?

James Zwach practices at 4405 E 26th St, Sioux Falls, SD 57103. The listed phone number is (605) 328-9000.

What is James Zwach's specialty?

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

Is James Zwach enrolled in Medicare?

Yes. James Zwach is registered in the Medicare PECOS enrollment system.

What insurance does James Zwach accept?

Health plans from Medica, Sanford Health Plan and Security Health Plan list James Zwach 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 James Zwach affiliated with any hospitals?

According to CMS data, James Zwach is affiliated with Sanford Usd Medical Center.

When was this NPI record last updated?

The NPPES record for James Zwach was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.