NPI registry status
Active
2026 NPPES data Family Medicine Physician NPI 1659513596 MD
Verify on CMS → Heather Clouse, MD
Family Medicine Physician in Sioux Falls, South Dakota.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 147,760 in Family Medicine Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
1K
Medicare Part D claims · 102 beneficiaries · Family Medicine Physician avg: 3K
MIPS score
100/100
▲ 17 pts above national avg 83.1 · Exceptional
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Heather Clouse, MD reported a CMS MIPS final score of 100/100 - above the 83.1 national average - and filed 1,178 Medicare Part D claims in 2023.
- 100/100
- MIPS score · +17 vs avg
- 1K
- Part D claims, 2023
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Heather Clouse, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
100 Top 7% higher than 93% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Heather Clouse, MD sits
This provider among family medicine physician peers
Across the 22,040 family medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Heather Clouse, MD writes more Part D claims than 36% of them and scores higher on MIPS quality than 95% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one family medicine physician peer from a representative sample of 60; the gold marker is Heather Clouse, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Heather Clouse, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Heather Clouse, MD?
High performer (top quartile)Primary specialty
Family Medicine Physician
Medicare Part D claims
1,178 66% vs specialty avg
MIPS final score
100/100 16.9 pts vs avg
Specialty distribution in South Dakota
How Family Medicine Physician compares to other specialties among South Dakota providers
Medicare quality performance, MIPS
Heather Clouse, MD's 2023 MIPS final score plotted against the Family Medicine Physician national average
- MIPS Final Score
- 100/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Family Medicine Physician) - 100/100 vs national avg 83.1
How MIPS and board certification work
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Heather Clouse, MD appears in the CMS NPPES registry as a Family Medicine Physician provider holding MD credentials at 1115 E 20TH ST, Sioux Falls, SD, 57105, with a listed phone of (605) 399-1783. NPI 1659513596 was issued on 03/24/2009.
Medicare Part D records for calendar year 2023 show 1,178 prescription claims written by this provider, covering 102 Medicare beneficiaries and totaling roughly $129K in drug spend, with an opioid prescribing rate of 4.2%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 100/100 for the 2023 performance year (Quality 95.3), compared with the national average of 83.1.
Family Medicine Physician is a high-volume specialty nationwide, with 147,760 enrolled providers across 56 states and an average of 3,418 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline.
Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1659513596 |
|---|---|
| Specialty | Family Medicine Physician |
| Credentials | MD |
| Gender | Female |
| NPI Issued | 03/24/2009 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
100
Final Score
Avg: 83.1
95.2573
Quality
96
Promoting Interoperability
Reporting: Group practice
Hospital and facility affiliations
Facilities where Heather Clouse, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Center For Family Medicine
Sioux Falls, SD
City OF Sioux Falls
Sioux Falls, SD
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
1,178
Total Claims
$129K
Total Drug Cost
102
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,908
- Total Day Supply
- 54,428
- Generic Drug Cost
- $20K
- Opioid Claims
- 49 (4.2% rate)
- Antibiotic Claims
- 18
Patient Demographics
- Average Patient Age
- 71.5 years
- Avg HCC Risk Score
- 1.39
- Gender Split
- 60% female / 40% male
- Age Distribution
- <65: 20, 65-74: 44, 75-84: 23, 85+: 15
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Heather Clouse, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Lisinopril
Lisinopril
82 claims
- Atorvastatin Calcium
Atorvastatin Calcium
79 claims
- Jardiance
Jardiance
52 claims
- Metformin Hcl
Metformin Hcl
35 claims
- Levothyroxine Sodium
Levothyroxine Sodium
34 claims
- Simvastatin
Simvastatin
34 claims
- Mirtazapine 28
Mirtazapine
28 claims
- Quetiapine Fumarate 28
Quetiapine Fumarate
28 claims
| Drug | Claims |
|---|---|
| Lisinopril | 82 |
| Atorvastatin Calcium | 79 |
| Jardiance Empagliflozin | 52 |
| Metformin Hcl | 35 |
| Levothyroxine Sodium | 34 |
| Simvastatin | 34 |
| Mirtazapine | 28 |
| Quetiapine Fumarate | 28 |
| Escitalopram Oxalate | 26 |
| Topiramate | 26 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Family Medicine Physician Overview
How Heather Clouse, MD fits within the Family Medicine Physician landscape nationally.
147,760
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider
Heather Clouse, MD's 1,178 claims are below the specialty average of 3,418.
Nearby Family Medicine Physician Providers in South Dakota
Other clinicians with the same primary specialty enrolled in South Dakota, drawn from the same CMS NPPES roster as Clouse.
Dr. Gordon Abernathie
D.O.
Rapid City, SD
Dr. Kyle Adams
D.O.
Rapid City, SD
Dr. Mary Ahlers
DO
Brookings, SD
Dr. Alese Allerdings
M.D.
De Smet, SD
Dr. Jay Allison
MD
Sioux Falls, SD
Compare Family Medicine Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the South Dakota medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Family Medicine Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
Healthcare Guides
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Medical Specialties Explained
Who treats what and how specialties differ
Understanding Medicare Claims Data
What prescribing data reveals about a provider
In-Network vs Out-of-Network
How insurance networks affect your costs
Telehealth Guide
Virtual care options and coverage in 2026
Explore South Dakota
Frequently Asked Questions
What is Heather Clouse, MD's specialty? ▼
Heather Clouse, MD specializes in Family Medicine Physician and practices in Sioux Falls, South Dakota. Credentials: MD.
How much does Heather Clouse, MD prescribe under Medicare Part D? ▼
In 2023, Heather Clouse, MD wrote 1,178 Medicare Part D claims totaling $129K in drug costs for 102 beneficiaries.
What is Heather Clouse, MD's Medicare quality score? ▼
Heather Clouse, MD has a CMS MIPS Final Score of 100/100 (Quality: 95.3). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Heather Clouse, MD located? ▼
Heather Clouse, MD is located at 1115 E 20TH ST, Sioux Falls, SD, 57105. Phone: (605) 399-1783.
What is Heather Clouse, MD's NPI number? ▼
Heather Clouse, MD's National Provider Identifier (NPI) is 1659513596, issued on 03/24/2009.
Does Heather Clouse, MD prescribe opioids? ▼
Yes, Heather Clouse, MD had 49 opioid claims in 2023 with an opioid prescribing rate of 4.2%.
How many Family Medicine Physician providers are there in the US? ▼
There are 147,760 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does Heather Clouse, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Heather Clouse, MD's most frequently prescribed drugs include Lisinopril, Atorvastatin Calcium, Jardiance. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Heather Clouse, MD accept Medicare? ▼
Heather Clouse, MD appears in CMS Medicare data with 1,178 Part D claims and 102 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Heather Clouse, MD's credentials? ▼
Heather Clouse, MD's NPI is 1659513596 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology
Compiled from official public sources by the PlainDoctor editorial team.
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.