DR. HEATHER M CLOUSE MD
NPI 1659513596
Family Medicine in Sioux Falls, SD

Q: What is Heather Clouse's NPI number?

The NPI number for Heather Clouse is 1659513596. It was assigned to this individual provider in the NPPES registry on March 24, 2009.

Q: What is Heather Clouse'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 Heather Clouse was last updated on April 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 March 24, 2009PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1115 E 20TH ST, SIOUX FALLS, SD 57105(605) 399-1783(605) 367-1757 Get Directions Write a Review

NPPES record last updated: April 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Heather M Clouse Md NPPES

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

DR. HEATHER M CLOUSE MD (NPI 1659513596) is an individual family medicine provider in Sioux Falls, South Dakota, licensed in South Dakota (8487) and active in the NPI registry since March 2009. She is enrolled in Medicare PECOS, is affiliated with Avera Mckennan Hospital & University Health Center, and is a graduate of Geisel School Of Medicine At Dartmouth (2009).

NPPES Registry Identity

NPI1659513596

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. HEATHER M CLOUSECredential: MD

Location Address1115 E 20TH STSioux Falls, SD 57105-1013

Mailing Address1115 E 20th StSioux Falls, SD 57105-1013 · (605) 399-1783 · Fax (605) 367-1757

Phone(605) 399-1783

Fax(605) 367-1757

Sole ProprietorNo

Medical School CMSGeisel School Of Medicine At DartmouthGraduated 2009

Enumeration DateMarch 24, 2009

Last NPPES UpdateApril 22, 2020

NPPES CertifiedApril 22, 2020

✔ NPI 1659513596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in SD · 8487

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.

1115 E 20TH ST, Sioux Falls, SD 57105

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Accepted Insurance

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

Dr. Heather M Clouse 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 ID8921439381

PECOS Enrollment IDI20200519001596

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 13

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.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

113 services36 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

76 services31 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.

71 services41 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.

39 services29 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

30 services17 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

21 services21 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

20 services20 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

18 services16 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

17 services14 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

17 services17 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

15 services12 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

12 services11 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Avera Mckennan Hospital & University Health Center

Acute Care Hospitals · Sioux Falls, SD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430016

Location1325 S Cliff AveSioux Falls, SD 57117 · Minnehaha 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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57105 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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

95.25

Promoting Interoperability

Improvement Activities

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.

TYLER LEE FABER

Family Medicine