NPIMap

Individual provider Active NPI

Sean C Pfeffer, MD

  • Family Medicine Physician
  • Joplin, MO
National Provider Identifier
1487690913
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2003026619 Issued in MO
Practice address
3130 Wisconsin Ave Ste 6
Joplin, MO 64804-2800
Phone
(417) 206-9300
Fax
(417) 206-9306
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2003026619 MO Primary

Addresses

Primary practice location

3130 Wisconsin Ave Ste 6
Joplin, MO 64804-2800

Mailing address

PO Box 2009
Joplin, MO 64803-2009
Phone (417) 206-9300

Other identifiers 3

IdentifierTypeStateIssuer
P00059304OtherRR MEDICARE
209223304MedicaidMO
183165OtherMOANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040323000283 MO Practitioner - Family Practice 1153228903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3130 Wisconsin Ave
Suite 6
Joplin, MO 64804-2800
Phone (417) 206-9300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.24 of 100Reported as group
Quality
83.33
Improvement activities
40
Cost
86.35

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2003026619MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunset Point Medical Associates Inc Family Medicine PastSince Jan 1, 1990 Accepting new patients
Palm Harbor Westchase Medical Group PA Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1487690913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2009",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648032009",
            "telephone_number": "417-206-9300",
            "fax_number": "417-206-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 WISCONSIN AVE STE 6",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042800",
            "telephone_number": "417-206-9300",
            "fax_number": "417-206-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEFFER",
        "first_name": "SEAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2003026619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00059304",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209223304",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "183165",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.