NPIMap

Individual provider Active NPI

Timothy J Metz, MD

  • Pain Medicine (Anesthesiology) Physician
  • Sioux Falls, SD
National Provider Identifier
1356410161
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
4713 Issued in SD
Practice address
911 E 20TH St Ste 602
Sioux Falls, SD 57105-1048
Phone
(605) 338-7098
Fax
(605) 335-3505
NPI assigned
Nov 7, 2006
Last updated
Apr 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 4713 SD Primary

Addresses

Primary practice location

911 E 20TH St Ste 602
Sioux Falls, SD 57105-1048

Mailing address

5105 S Pennbrook Ave
Sioux Falls, SD 57108-2990
Phone (605) 338-0500

Other identifiers 5

IdentifierTypeStateIssuer
532754MedicaidIA
96D03MEOtherMNBLUE CROSS MN
4997536OtherSDBLUE CROSS SD
5700900MedicaidSD
590007700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100603000996 SD Practitioner - Anesthesiology 5991834764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Sanford School of Medicine of University of South Dakota, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1301 S Cliff Ave
Suite 401
Sioux Falls, SD 57105-1023
Phone (605) 322-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4713SDMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jan 1, 2017 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Jan 1, 2017 Accepting new patients

Locations

1301 S Cliff Ave
Ste 401
Sioux Falls, SD 57105
Phone (605) 322-7300

1301 S Cliff Ave
Ste 610
Sioux Falls, SD 57105
Phone (605) 322-8860

911 E 20th St
Ste 602
Sioux Falls, SD 57105
Phone (605) 335-3346

Interoperability endpoints

  • Direct secure messaging: timothy.metz@avera.sdhealthlink.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    Medicare reassignment Care Compare group NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera Rehabilitation Associates

    • Physical Medicine & Rehabilitation Physician
    • Sioux Falls, SD
    • NPI 1841427770
    NPD

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1356410161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 S PENNBROOK AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082990",
            "telephone_number": "605-338-0500",
            "fax_number": "605-335-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E 20TH ST STE 602",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051048",
            "telephone_number": "605-338-7098",
            "fax_number": "605-335-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZ",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SD",
            "license": "4713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "532754",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MN",
            "identifier": "96D03ME",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SD",
            "identifier": "4997536",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5700900",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590007700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.