Trevor Mark Wolterstorff

Primary specialty

PsychologistTaxonomy code 103T00000X

License

642 Issued in SD

Practice address

7511 S Louise Ave
Sioux Falls, SD 57108-5997

Phone

(605) 312-8700

Fax

(757) 446-8401

NPI assigned

Mar 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027

Merit-based Incentive Payment System (MIPS)

Final score

84.78 of 100Reported as group

Quality

78.77

Promoting interoperability

100

Improvement activities

40

Cost

70.49

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sanford Medical Center

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342
  Medicare reassignment Care Compare group NPD
• Sanford Medical Center

  • General Acute Care Hospital
  • Sioux Falls, SD
  • NPI 1821017880
  NPD

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

• Sanford Medical Center

  • Air Ambulance
  • Sioux Falls, SD
  • NPI 1023299708

  Hospital

  Care Compare affiliation
• Sanford Medical Center

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342

  Hospital

  Care Compare affiliation
• Sanford Medical Center

  • General Acute Care Hospital
  • Sioux Falls, SD
  • NPI 1821017880
  Care Compare affiliation

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1639637689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 S LOUISE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085997",
            "telephone_number": "605-312-8700",
            "fax_number": "757-446-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTERSTORFF",
        "first_name": "TREVOR",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-08",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SD",
            "license": "642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lee Wollan, RN
• Riley Wolles, LCSW, QMHP
• Adam N Wollman, CRNA
• Jenifer M. Wollman, PHARMD, CSP
• Faith Wollmann, BCBA
• Adam John Wolthuizen, MS, LPC-MH, NCC,QMHP
• Matthew E Wolthuizen, MA, LPCMH, NCC, QMHP
• Carol Woltzen, MA CCC-SLP
• Wonderful-Home
• Gisella Sarita Wong Nano, M.D.

• Psychologist in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Psychologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.