DR. ANTHONY J. HERICKS D.O.
NPI 1689606303
Internal Medicine - Critical Care Medicine in Sioux Falls, SD

Q: What is Anthony Hericks's NPI number?

The NPI number for Anthony Hericks is 1689606303. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Q: What is Anthony Hericks's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Hericks was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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 July 06, 2006PECOS EnrolledAccepts Medicare Assignment

810 E 23RD ST STE 300, SIOUX FALLS, SD 57105(605) 322-6930(605) 322-6931 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 14, 2026, Oct 15, 2018 (2 updates tracked since 2018).

On this page

About Dr. Anthony J. Hericks D.o. NPPES

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

DR. ANTHONY J. HERICKS D.O. (NPI 1689606303) is an individual critical care medicine provider in Sioux Falls, South Dakota, licensed in South Dakota (7494) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Spencer Municipal Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1689606303

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameDR. ANTHONY J. HERICKSCredential: D.O.

Location Address810 E 23RD ST STE 300Sioux Falls, SD 57105-2135

Mailing Address810 E 23rd St Ste 300Sioux Falls, SD 57105-2135 · (605) 322-6930 · Fax (605) 322-6931

Phone(605) 322-6930

Fax(605) 322-6931

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateJuly 6, 2006

Last NPPES UpdateJanuary 14, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 14, 2026

✔ NPI 1689606303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

Licenses✔ Licensed in SD · 7494✔ Licensed in MO · 2006013162

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 2006013162 (MO)

810 E 23RD ST STE 300, Sioux Falls, SD 57105

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Other Identifiers 3

Medicaid6632210SD

Medicaid6632212SD

OtherP00738068SD · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware 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

Dr. Anthony J. Hericks D.o. 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 ID8123916285

PECOS Enrollment IDI20090813000255, I20250312001223

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 Reassignment

Medicare enrollment records show Anthony Hericks reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Avera Mckennan

1.0 mi

Transplant Surgery

801 E 23RD ST STE 401
Sioux Falls, SD 57105

Reassigned Medicare billing, South Dakota, Iowa and Minnesota enrollments
Also billed through NPI 1104892892 (Minnesota)
1,277 clinicians in this Medicare group

NPI 1730155425 (605) 322-7350

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 23

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.

Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation G0399

A Home Sleep Test (HST) with a Type III Portable Monitor is an unattended test that records your breathing, heart rate, and oxygen levels during sleep. This test uses a minimum of 4 channels to monitor these parameters, helping to diagnose sleep disorders.

385 services381 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

274 services216 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

258 services244 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

210 services196 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

183 services180 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

144 services141 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

132 services129 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

126 services51 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

121 services120 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.

121 services63 patients

Test to examine how well the lungs exchange gases 94729

89 services87 patients

Test to determine lung volumes using sensors 94726

73 services71 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

68 services56 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

54 services53 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

45 services45 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

40 services39 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

31 services31 patients

Sleep study including heart rate, breathing, airflow, and effort 95806

A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.

29 services29 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

26 services16 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

24 services22 patients

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes 31652

This procedure involves a special tube with a camera (endoscope) entering your lung airways. Guided by ultrasound, it collects samples from 1-2 lymph nodes. This helps doctors understand and diagnose potential issues in your lungs.

14 services14 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.

13 services13 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Spencer Municipal Hospital

Acute Care Hospitals · Spencer, IA

5/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number160112

Location1200 1st Avenue EastSpencer, IA 51301 · Clay County

Emergency services Birthing friendly

Lakes Regional Healthcare

Acute Care Hospitals · Spirit Lake, IA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number160124

Location2301 Highway 71Spirit Lake, IA 51360 · Dickinson County

Emergency services Birthing friendly

Avera St Mary's Hospital

Acute Care Hospitals · Pierre, SD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430015

Location801 E SiouxPierre, SD 57501 · Hughes County

Emergency services Birthing friendly

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

Avera Heart Hospital Of South Dakota

Acute Care Hospitals · Sioux Falls, SD

5/5 CMS rating

OwnershipProprietary

CMS Certification Number430095

Location4500 W 69th StSioux Falls, SD 57108 · Lincoln County

Emergency services

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

$126.78 typical visit price

range $55.52 – $167.23

Typical copayment $31.69 (range $13.88 – $41.80)

Most-billed visit code 99204

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 32

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

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

DME-Other DME · category DE001N

25 suppliers242 claims242 services$37.68 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

7 suppliers14 claims41 services$1.72 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005

DME-Other DME · category DE000N

9 suppliers28 claims28 services$17.40 avg. paid by Medicare

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

DME-Other DME · category DE001N

24 suppliers210 claims210 services$102.28 avg. paid by Medicare

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

DME-Other DME · category DE001N

25 suppliers244 claims708 services$37.54 avg. paid by Medicare

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

DME-Other DME · category DE001N

15 suppliers69 claims399 services$20.70 avg. paid by Medicare

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

DME-Other DME · category DE001N

6 suppliers15 claims87 services$17.41 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

20 suppliers99 claims99 services$63.52 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

29 suppliers204 claims204 services$20.69 avg. paid by Medicare

Chinstrap used with positive airway pressure device A7036

DME-Other DME · category DE001N

8 suppliers26 claims26 services$10.68 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

9 suppliers23 claims23 services$18.50 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

28 suppliers247 claims1,384 services$2.63 avg. paid by Medicare

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

DME-Other DME · category DE001N

26 suppliers136 claims136 services$12.29 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

6 suppliers61 claims61 services$20.32 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers13 claims13 services$37.26 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

3 suppliers39 claims39 services$878.38 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

8 suppliers111 claims111 services$103.39 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

13 suppliers234 claims235 services$15.56 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

8 suppliers129 claims131 services$6.49 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

13 suppliers248 claims249 services$42.86 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

16 suppliers249 claims249 services$103.03 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

8 suppliers123 claims123 services$35.61 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary G0333

DME-Other DME · category DE000N

15 suppliers16 claims16 services$44.95 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

18 suppliers136 claims9,240 services$4.49 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

31 suppliers225 claims14,520 services$6.42 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

8 suppliers20 claims6,097 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

19 suppliers54 claims4,686 services$0.09 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

46 suppliers378 claims23,494 services$0.80 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

1 supplier13 claims606 services$0.16 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

15 suppliers110 claims598,500 services$0.15 avg. paid by Medicare

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

DME-Other DME · category DE000N

49 suppliers440 claims440 services$25.67 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 90 days Q0514

DME-Other DME · category DE000N

6 suppliers11 claims11 services$52.08 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.

AVERA MCKENNAN

Internal Medicine (Pulmonary Disease)

810 E 23RD ST STE 300
SIOUX FALLS, SD 57105

Minnehaha County (605) 322-6930

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 Anthony Hericks's NPI number?

The NPI number for Anthony Hericks is 1689606303. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Anthony Hericks located?

Anthony Hericks practices at 810 E 23rd St Ste 300, Sioux Falls, SD 57105. The listed phone number is (605) 322-6930.

What is Anthony Hericks's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Anthony Hericks enrolled in Medicare?

Yes. Anthony Hericks 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 organization bills Medicare for Anthony Hericks's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anthony Hericks reassigns Medicare benefits to Avera Mckennan (Sioux Falls, SD). The 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 Anthony Hericks's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Anthony Hericks accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Avera Health Plans and Oscar Insurance Company and 2 other insurers list Anthony Hericks 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 Anthony Hericks affiliated with any hospitals?

According to CMS data, Anthony Hericks is affiliated with Spencer Municipal Hospital, Lakes Regional Healthcare, Avera St Mary's Hospital, Avera Mckennan Hospital & University Health Center and Avera Heart Hospital Of South Dakota.

When was this NPI record last updated?

The NPPES record for Anthony Hericks was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.