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    OpenPayerNPI Medicare & MedicaidSioux Falls Specialty Hospital, LLP
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    Sioux Falls Specialty Hospital, LLP — Billing Profile & Reimbursement Data

    NPI 1316946809 · Sioux Falls, SD · Special Hospital

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    Sioux Falls Specialty Hospital, LLP is a special hospital provider located in Sioux Falls, South Dakota. This profile covers 0 Medicare and 5 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationSioux Falls Specialty Hospital, LLP
    Address910 E 20th St
    CitySioux Falls
    StateSD
    ZIP57105
    TaxonomySpecial Hospital
    NPI EnumeratedJuly 18, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$1.3M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    5 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    41899Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.2,390$380$904.9K
    00170The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.1,700$150$251.5K
    U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc210$480$102.9K
    69436This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.20$270$4K
    99188The provider applies a fluoride adhesive over the tooth surface to prevent tooth decay, provide remineralization, or treat hypersensitivity.2,330$0$0

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. South Dakota median

    5 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    41899Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.210150$400$440.3K
    00170The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.720130$150$248.6K
    69436This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.81030$260$99.6K
    U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc1130180$40$22.1K
    99188The provider applies a fluoride adhesive over the tooth surface to prevent tooth decay, provide remineralization, or treat hypersensitivity.330280$20$19.6K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Sioux Falls Specialty Hospital, LLP, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    James SullivanMNDiagnostic Radiology Physician$589.8K$0
    Michael McneeleyMNDiagnostic Radiology Physician$477.8K$0
    Leo FlynnSDDiagnostic Radiology Physician$457K$0
    Syed ShahSDInternal Medicine Physician$230.5K$0
    Robert RabieaFLDiagnostic Radiology Physician$199.6K$0
    Andrew TyanMDDiagnostic Radiology Physician$172.4K$0
    Thomas PopeSCDiagnostic Radiology Physician$133K$29K
    Peter BusselbergMNDiagnostic Radiology Physician$154.7K$0
    Thomas GilbertMNDiagnostic Radiology Physician$148.8K$0
    Erik PetersonSDOrthopaedic Surgery Physician$139.7K$0

    Nearby Providers

    Other providers in the same ZIP code as Sioux Falls Specialty Hospital, LLP, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    South Dakota AchieveSDDevelopmental Disabilities Clinic/Center$0$166.9M
    DakotabilitiesSDVoluntary or Charitable Agency$0$77.8M
    Sanford Medical CenterSDFamily Medicine Physician$0$68.8M
    Volunteers Of America, DakotasSDIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$60.9M
    Southeastern Behavioral HealthcareSDMental Health Clinic/Center (Including Community Mental Health Center)$0$59.1M
    Resouces For Human Development, Inc.SDIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$31.1M
    Sanford Medical CenterSDGeneral Acute Care Hospital$0$24.4M
    Childrens Dental CenterSDPediatric Dentistry$0$24M
    Sanford Medical CenterSDAir Ambulance$0$11.9M
    Avera MckennanSDFamily Medicine Physician$0$10.6M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. South Dakota Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. South Dakota Distribution
    Sioux Falls Specialty Hospital, LLP — 0 of 4 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Dakota