MRS. CAROLYN JEAN DUENWALD PA-C
NPI 1720032261
Physician Assistant in Sioux Falls, SD
NPI Status: Active since May 20, 2006
Contact Information
2501 W 22ND ST
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 336-3230
- Individual
- Female
- Years of Experience 21
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About CAROLYN DUENWALD
This page provides the complete NPI Profile along with additional information for Carolyn Duenwald, a primary care provider established in Sioux Falls, South Dakota with a medical specialization in Physician Assistant and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1720032261 assigned on May 2006. The practitioner's primary taxonomy code is 363A00000X with license number 0605 (SD). The provider is registered as an individual and her NPI record was last updated 14 years ago.
- NPI
- 1720032261
- Provider Name
- MRS. CAROLYN JEAN DUENWALD PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2501 W 22ND ST SIOUX FALLS, SD 57105
- Location Phone
- (605) 336-3230
- Mailing Address
- 2501 W 22ND ST SIOUX FALLS, SD 57105
- Medical School Name
- OTHER
- Graduation Year
- 2005
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-20-2006
- Last Update Date
- 03-09-2012
- Code Navigator
A primary care provider (PCP) like Carolyn Duenwald sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 0605
- License State
- SD
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Avera Direct $2000 - HMO
- Avera Direct $4500 - HMO
- Avera Direct $6000 - HMO
- Avera Direct $7500 HSA Eligible HDHP - HMO
- Avera Direct MyWeighForward $1800 - HMO
- Avera Direct MyWeighForward $4000 - HMO
- Avera Direct Standard $1500 - HMO
- Avera Direct Standard $5000 - HMO
- Avera Direct Standard $7500 - HMO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - EPO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - EPO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - EPO
- Medica Individual Choice Silver Standard - HMO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
- Medica Insure Bronze Premier - EPO
- Wellmark Bronze HDHP HMO HSA Qualified - HMO
- Wellmark Bronze Traditional HMO - HMO
- Wellmark Gold Traditional HMO - HMO
- Wellmark Silver Traditional HMO - HMO
- Wellmark Standard Bronze HMO - HMO
- Wellmark Standard Gold HMO - HMO
- Wellmark Standard Silver HMO - HMO
- Wellmark Bronze HDHP EPO HSA Qualified - EPO
- Wellmark Bronze Traditional EPO - EPO
- Wellmark Gold Traditional EPO - EPO
- Wellmark Silver Traditional EPO - EPO
- Wellmark Standard Bronze EPO - EPO
- Wellmark Standard Gold EPO - EPO
- Wellmark Standard Silver EPO - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Carolyn Duenwald is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Carolyn Duenwald is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 5395972343
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20131218001359
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration of fluid from chest cavity using imaging guidance
Drainage of fluid from abdominal cavity using imaging guidance
Established patient office or other outpatient visit, 10-19 minutes
Follow-up hospital inpatient care per day, typically 15 minutes
New patient office or other outpatient visit, 30-44 minutes
Removal of tunneled central venous tube
This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.
This service was performed 24 times for 19 patientsThis procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.
This service was performed 133 times for 45 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 34 times for 26 patientsFollow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
This service was performed 103 times for 71 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 36 times for 36 patientsA tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.
This service was performed 16 times for 16 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.3 for a new patient copayment and $17.3 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 57105 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.21
- Minimum New Patient Price $55.52
- Maximum New Patient Price $167.23
- Average New Patient Copayment $21.3
- Minimum New Patient Copayment $13.88
- Maximum New Patient Copayment $41.8
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.2
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $137.08
- Average Established Patient Copayment $17.3
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.27
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 2% | 149 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Colorectal Cancer Screening | 61% | 265 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Documentation of Current Medications in the Medical Record | 85% | 1087 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 100% | 898 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Medication Reconciliation | 98% | 1110 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 94% | 586 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 1% | 169 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% | 107 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Carolyn Duenwald is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER | 1325 S CLIFF AVE SIOUX FALLS, SD 57117 | (605) 322-8000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 2 | 0 | 0 | 3 | 2 | 2 | 6 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 4 | 0 | 0 | 3 | 4 | 2 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 4 + 0 + 0 + 3 + 4 + 2 + 1 + 2 + 24 = 49 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 49 = 1 | 1 | ||||||||
The NPI number 1720032261 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1306840111 | DR. DOUGLAS D. TASSI O.D. Individual | Optometrist | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1891757258 | DR. STEVEN CRAIG JULIUS M.D. Individual | Psychiatry & Neurology (Neurology) | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 333-6843 |
| 1801847892 | DR. JAMES ROSS HORNING M.D. Individual | Internal Medicine | 2501 W 22ND ST RC JOHNSON VA HOSPITAL SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1164474516 | DR. CHRISTOPHER JAY PIERSON D.C. Individual | Chiropractor | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1346292489 | KAREN ANN BANKEN PA-C Individual | Physician Assistant | 2501 W 22ND ST ATTN: SURGERY SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1467405571 | MRS. PATRICIA ANN LOOBY PA-C Individual | Physician Assistant (Medical) | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1245284868 | DR. GEORGE ALVAREZ RICHARDS M.D. Individual | Psychiatry & Neurology (Psychiatry) | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1639124407 | RACHEL ANNE MCCRACKEN MB. CHB. Individual | Psychiatry & Neurology (Psychiatry) | 2501 W 22ND ST 116C SIOUX FALLS, SD 57105 (605) 333-6865 |
| 1841245941 | ROSA LUNDIN MD Individual | Family Medicine | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1366482168 | KRISTI MICHELLE LAUSENG MPT Individual | Physical Therapist | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1528008273 | LORETTA VANHOVE CNP Individual | Nurse Practitioner (Family) | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 333-6811 |
| 1760425813 | DEBORAH KAREN MCCAULEY PT Individual | Physical Therapist | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 333-6833 |
| 1295779643 | AUDREY M KOST Individual | Physician Assistant | 2501 W 22ND ST PO BX 5046 SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1346285327 | DR. ROBERT FRANCIS ECKERSTORFER DPM Individual | Podiatrist | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1053356733 | KELLEY J OEHLKE PHARM.D. Individual | Pharmacist | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1811933807 | SUSAN C LEITHEISER CNP Individual | Nurse Practitioner (Family) | 2501 W 22ND ST PRIMARY CARE - 111A SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1972549350 | DONNA R. PARRY CNP Individual | Nurse Practitioner (Family) | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1619903424 | CINDY MAE KHAN RPTA Individual | Physical Therapy Assistant | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1831125012 | LARRY STEVEN STRELECK D.D.S. Individual | Dentist | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
| 1447286216 | KENNETH DEWAYNE JOHNSON R.D., L.N. Individual | Dietitian, Registered | 2501 W 22ND ST SIOUX FALLS, SD 57105 (605) 336-3230 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720032261, enumerated in the NPI registry as an "individual" on May 20, 2006
The provider is located at 2501 W 22nd St Sioux Falls, Sd 57105 and the phone number is (605) 336-3230
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider has more than 21 years of experience.
The provider might be accepting Accepts: Avera Health Plans, Medica, Wellmark Health Plan. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $85.21 with an average copayment of $21.3 for new patient appointments. Established patients should expect a typical charge of $69.2 and an average copayment of 17.3. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Aspiration of fluid from chest cavity using imaging guidance, Drainage of fluid from abdominal cavity using imaging guidance, Established patient office or other outpatient visit, 10-19 minutes, Follow-up hospital inpatient care per day, typically 15 minutes, New patient office or other outpatient visit, 30-44 minutes and Removal of tunneled central venous tube.
The practitioner is affiliated to the following hospital(s): AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on May 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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