NPI registry status
Active
2026 NPPES data Pediatric Surgery Physician NPI 1295782613 MD
Verify on CMS → Stephen Karl, MD
Pediatric Surgery 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 1,132 in Pediatric Surgery 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
15
Medicare Part D claims · Pediatric Surgery Physician avg: 272
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Stephen Karl, MD filed 15 Medicare Part D claims in 2023 as a Pediatric Surgery Physician in Sioux Falls, South Dakota.
- 15
- Part D claims, 2023
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.
Stephen Karl, MD's Medicare Part D volume vs every U.S. prescriber
Total Medicare Part D claims, 2023, across all CMS prescribers nationally
15 0th percentile higher than 0% of 1,370,886 prescribers
Each bar is a band; taller bars hold more prescribers. 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 Medicare Part D Prescriber Public Use File · 2023
◑
Board-eligible specialty (heuristic, not verified)
Stephen Karl, MD practices in an ABMS-board-eligible specialty but we don't have enough CMS-participation signals to confirm active board-certified status. Consult CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Stephen Karl, MD?
Quality data not reportedPrimary specialty
Pediatric Surgery Physician
Medicare Part D claims
15 94% vs specialty avg
Specialty distribution in South Dakota
How Pediatric Surgery Physician compares to other specialties among South Dakota providers
Board certification
Not published by CMS
CMS does not publish a per-provider board-certification field in NPPES. PlainDoctor does not have a reliable per-specialty certification rate to show for Pediatric Surgery Physician. Verify directly:
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).
Stephen Karl, MD appears in the CMS NPPES registry as a Pediatric Surgery Physician provider holding MD credentials at 1001 E 21ST ST, Sioux Falls, SD, 57105, with a listed phone of (605) 322-7530. NPI 1295782613 was issued on 05/30/2006.
Medicare Part D records for calendar year 2023 show 15 prescription claims written by this provider, covering N/A Medicare beneficiaries and totaling roughly $207 in drug spend.
Pediatric Surgery Physician is a narrow specialty nationwide, with 1,132 enrolled providers across 52 states and an average of 272 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 | 1295782613 |
|---|---|
| Specialty | Pediatric Surgery Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 05/30/2006 |
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
15
Total Claims
$207
Total Drug Cost
N/A
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 45
- Total Day Supply
- 1,350
- Brand Drug Cost
- $0
- Generic Drug Cost
- $207
Patient Demographics
- Average Patient Age
- 76.0 years
- Avg HCC Risk Score
- 0.40
Pediatric Surgery Physician Overview
How Stephen Karl, MD fits within the Pediatric Surgery Physician landscape nationally.
1,132
Pediatric Surgery Physician Providers in US
52
States with Pediatric Surgery Physician
272
Avg Claims per Provider
Stephen Karl, MD's 15 claims are below the specialty average of 272.
Nearby Pediatric Surgery Physician Providers in South Dakota
Other clinicians with the same primary specialty enrolled in South Dakota, drawn from the same CMS NPPES roster as Karl.
Compare Pediatric Surgery 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 Pediatric Surgery 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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How to Find a Doctor
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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
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Explore South Dakota
Frequently Asked Questions
What is Stephen Karl, MD's specialty? ▼
Stephen Karl, MD specializes in Pediatric Surgery Physician and practices in Sioux Falls, South Dakota. Credentials: MD.
How much does Stephen Karl, MD prescribe under Medicare Part D? ▼
In 2023, Stephen Karl, MD wrote 15 Medicare Part D claims totaling $207 in drug costs for N/A beneficiaries.
Where is Stephen Karl, MD located? ▼
Stephen Karl, MD is located at 1001 E 21ST ST, Sioux Falls, SD, 57105. Phone: (605) 322-7530.
What is Stephen Karl, MD's NPI number? ▼
Stephen Karl, MD's National Provider Identifier (NPI) is 1295782613, issued on 05/30/2006.
How many Pediatric Surgery Physician providers are there in the US? ▼
There are 1,132 Pediatric Surgery Physician providers across 52 states in the US. The average Pediatric Surgery Physician provider writes 272 Medicare Part D claims per year.
Does Stephen Karl, MD accept Medicare? ▼
Stephen Karl, MD appears in CMS Medicare data with 15 Part D claims and N/A Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Stephen Karl, MD's credentials? ▼
Stephen Karl, MD's NPI is 1295782613 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.
- 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.