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THERESA MICHELLE NEWCOMB APRN-NP
NPI 1962939231
Nurse Practitioner - Family in Sioux Falls, SD

Active since May 17, 2017PECOS EnrolledAccepts Medicare Assignment
2601 S ELLIS RD, SIOUX FALLS, SD 57106(605) 332-2883(605) 323-8283 Get Directions Write a Review

NPPES record last updated: August 22, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 22, 2024, May 17, 2017 (2 updates tracked since 2017).

About Theresa Michelle Newcomb Aprn-np NPPES

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

THERESA MICHELLE NEWCOMB APRN-NP (NPI 1962939231) is an individual family provider in Sioux Falls, South Dakota, licensed in South Dakota (CP001728) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS, is affiliated with Sanford Usd Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1962939231
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTHERESA MICHELLE NEWCOMBCredential: APRN-NP
Location Address2601 S ELLIS RDSioux Falls, SD 57106-7067
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-9419
Phone(605) 332-2883
Fax(605) 323-8283
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 17, 2017
Last NPPES UpdateAugust 22, 20242 updates tracked since enumeration
NPPES CertifiedAugust 22, 2024
✔ NPI 1962939231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in SD · CP001728✔ Licensed in NE · 112207
2601 S ELLIS RD, Sioux Falls, SD 57106
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Sanford Health Plan, Security Health Plan 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 Michelle Newcomb Aprn-np 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 ID9537434477
PECOS Enrollment IDI20200507002096
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 Newcomb reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sanford Clinic
2.1 mi
Clinic/Center
2310 S MARION RD STE 140
Sioux Falls, SD 57106
  • Reassigned Medicare billing, South Dakota enrollment
  • 826 clinicians in this Medicare group
NPI 1164069506 (605) 328-6690
Avera Mckennan
3.3 mi
Emergency Medicine
4500 W 69TH ST
Sioux Falls, SD 57108
  • Reassigned Medicare billing, South Dakota enrollment
  • 1,277 clinicians in this Medicare group
NPI 1013350891 (605) 322-9777
Sanford Medical Center
4.4 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

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

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.
16 services16 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 57106 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.

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.

LIEN LIEVE SWIERINGA NP
Nurse Practitioner (Women's Health)
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 312-3000
SANFORD VIRTUAL CARE
Clinic/Center (Multi-Specialty)
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 332-2883
JENNIFER SUSANNE SENGE CNP
Nurse Practitioner (Obstetrics & Gynecology)
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 312-3000
JILL MARIE MELBY CNP
Nurse Practitioner (Family)
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 328-9600
SUSAN DINSMORE MA, LMFT
Marriage & Family Therapist
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 312-3000
DAVID KAPPERMAN MD
Family Medicine
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 312-3000
DR. BIANCA JOHNSON MD
Pediatrics
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 312-3000
CARLEIGH R BELUSH PNP
Nurse Practitioner (Pediatrics)
2601 S ELLIS RD
SIOUX FALLS, SD 57106
Minnehaha County (605) 312-3000

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 Newcomb's NPI number?

The NPI number for Theresa Newcomb is 1962939231. It was assigned to this individual provider in the NPPES registry on May 17, 2017.

Where is Theresa Newcomb located?

Theresa Newcomb practices at 2601 S Ellis Rd, Sioux Falls, SD 57106. The listed phone number is (605) 332-2883.

What is Theresa Newcomb's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Theresa Newcomb enrolled in Medicare?

Yes. Theresa Newcomb 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 Newcomb's services?

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

What insurance does Theresa Newcomb accept?

Health plans from Avera Health Plans, Sanford Health Plan, Security Health Plan, Wellmark Health Plan of Iowa, Inc. and Wellmark of South Dakota, Inc. list Theresa Newcomb 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 Newcomb affiliated with any hospitals?

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

When was this NPI record last updated?

The NPPES record for Theresa Newcomb was last updated on August 22, 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.