Clayton Gerald Vanbalen, MD - Medicare Preventive Medicine in Sioux Falls, SD

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Clayton Gerald Vanbalen, MD is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in Sioux Falls, South Dakota. He went to Sanford School Of Medicine Of University Of South Dakota and graduated in 1979 and has 45 years of diverse experience with area of expertise as Preventive Medicine. He is a member of the group practice Avera St Marys and his current practice location is 900 E 54th St N, Sioux Falls, South Dakota. You can reach out to his office (for appointments etc.) via phone at (605) 338-9300.

Clayton Gerald Vanbalen is licensed to practice in South Dakota (license number 2540) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1316943251.

Contact Information

Clayton Gerald Vanbalen, MD
900 E 54th St N,
Sioux Falls, SD 57104
(605) 338-9300
(605) 338-9301

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Physician's Profile

Full NameClayton Gerald Vanbalen
GenderMale
SpecialityPreventive Medicine
Experience45 Years
Location900 E 54th St N, Sioux Falls, South Dakota
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Clayton Gerald Vanbalen attended and graduated from Sanford School Of Medicine Of University Of South Dakota in 1979
  NPI Data:
  • NPI Number: 1316943251
  • Provider Enumeration Date: 06/24/2005
  • Last Update Date: 03/02/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0345210753
  • Enrollment ID: I20041101000769

Medical Identifiers

Medical identifiers for Clayton Gerald Vanbalen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316943251NPI-NPPES
5602923MedicaidSD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2083P0500XPreventive Medicine - Preventive Medicine/occupational Environmental Medicine 2540 (South Dakota)Secondary
2083X0100XPreventive Medicine - Occupational Medicine 2540 (South Dakota)Primary
207Q00000XFamily Medicine 2540 (South Dakota)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Avera St Mary's HospitalPierre, SDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Avera St Marys014313496582

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Clayton Gerald Vanbalen allows following entities to bill medicare on his behalf.
Entity NameAvera Mckennan
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003389206
PECOS PAC ID: 0345157103
Enrollment ID: O20031110000117
Entity NameSanford Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396764254
PECOS PAC ID: 0244143824
Enrollment ID: O20031110000532
Entity NameSanford Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821017880
PECOS PAC ID: 8325950215
Enrollment ID: O20040115000388
Entity NameAvera St Marys
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669457180
PECOS PAC ID: 0143134965
Enrollment ID: O20040225000579

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Clayton Gerald Vanbalen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Clayton Gerald Vanbalen, MD
Po Box 5074,
Sioux Falls, SD 57117-5074

Ph: (605) 328-6585		Clayton Gerald Vanbalen, MD
900 E 54th St N,
Sioux Falls, SD 57104

Ph: (605) 338-9300

Reviews and Comments


Preventive Medicine Doctors in Sioux Falls, SD

Ronald Mark Rossing, MD
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 900 E 54th St N, Sioux Falls, SD 57104
Phone: 605-328-9300    Fax: 605-328-9301
Bruce Alden Elkins, M.D.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 4928 N Cliff Ave, Sioux Falls, SD 57104
Phone: 605-322-5100    
John Alan Hansen Jr., MD
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1321 W 22nd St Ste Lower, Sioux Falls, SD 57105
Phone: 605-328-1990    Fax: 605-328-1991
Rachel E Thies, MD
Preventive Medicine
Medicare: Medicare Enrolled
Practice Location: 900 E 54th St N Ste 200, Sioux Falls, SD 57104
Phone: 605-328-9300    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.