FANNY M JAQUEZ MD
NPI 1740212208
Psychiatry & Neurology - Neurology in Sioux Falls, SD
About Fanny M Jaquez Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FANNY M JAQUEZ MD (NPI 1740212208) is an individual neurology provider in Sioux Falls, South Dakota, licensed in Georgia (054903) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Tanner Medical Center Villa Rica, and maintains a secondary practice location in Riverdale.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted 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
Fanny M Jaquez 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.
Medicare Billing Reassignments
3Medicare enrollment records show Fanny Jaquez reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Sioux Falls, SD 57104
- Reassigned Medicare billing, South Dakota enrollment
- 826 clinicians in this Medicare group
Carrollton, GA 30117
- Reassigned Medicare billing, Georgia enrollment
- 232 clinicians in this Medicare group
Riverdale, GA 30274
- Reassigned Medicare billing, Georgia enrollment
- 111 clinicians in this Medicare group
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 2
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Tanner Medical Center Villa Rica
Acute Care Hospitals · Villa Rica, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 57104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
SIOUX FALLS, SD 57104
SIOUX FALLS, SD 57104
SIOUX FALLS, SD 57104
SIOUX FALLS, SD 57104
SIOUX FALLS, SD 57104
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 Fanny Jaquez's NPI number?
The NPI number for Fanny Jaquez is 1740212208. It was assigned to this individual provider in the NPPES registry on July 7, 2006.
Where is Fanny Jaquez located?
Fanny Jaquez practices at 1210 W 18th St Ste 100, Sioux Falls, SD 57104. The listed phone number is (605) 312-8500.
What is Fanny Jaquez's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.
Is Fanny Jaquez enrolled in Medicare?
Yes. Fanny Jaquez 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 Fanny Jaquez's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Fanny Jaquez reassigns Medicare benefits to 3 organizations: Sanford Clinic (Sioux Falls, SD), Tanner Medical Group Inc (Carrollton, GA) and Southern Regional Physicians Management Group, LLC (Riverdale, GA). 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 Fanny Jaquez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Fanny Jaquez accept?
Health plans from Security Health Plan, Wellmark Health Plan of Iowa, Inc. and Wellmark of South Dakota, Inc. list Fanny Jaquez 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 Fanny Jaquez affiliated with any hospitals?
According to CMS data, Fanny Jaquez is affiliated with Tanner Medical Center Villa Rica.
When was this NPI record last updated?
The NPPES record for Fanny Jaquez was last updated on March 25, 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.
# Fanny M Jaquez, MD · NPI 1740212208
Neurology physician in Sioux Falls, South Dakota. Individual provider, active in the CMS NPPES registry since July 7, 2006.
## Identity
- **NPI:** 1740212208 (Entity type: Individual)
- **Enumerated:** July 7, 2006
- **Primary specialty:** Psychiatry & Neurology - Neurology · taxonomy 2084N0400X
- **State license:** 054903 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1210 W 18TH ST, STE 100, Sioux Falls, SD 57104
- **Phone:** (605) 312-8500 · **Fax:** (605) 312-8501
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Sanford Clinic (NPI 1457383424, Sioux Falls, SD); Tanner Medical Group Inc (NPI 1396979787, Carrollton, GA); Southern Regional Physicians Management Group, LLC (NPI 1043677271, Riverdale, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1985
## Record status
- **NPPES last updated:** March 25, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1740212208) · Data from the CMS NPPES public registry.