Mark J Ptacek, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4872 Issued in SD

Practice address

71 Charles St
Deadwood, SD 57732-1303

Phone

(605) 717-6431

NPI assigned

Jul 7, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in SD, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Nebraska College of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Travis J Ptacek MD PLLCGroup PAC ID 1658725692, 10 clinicians

Monument Health Network IncGroup PAC ID 5991616427, 163 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Monument Health Custer Hospital Hospital, Custer, SD, CCN 431323

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mptacek.13940@regionalhealth.sdhealthlink.net

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Atkinson

  • Skilled Nursing Facility
  • Atkinson, NE
  • NPI 1679563027

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Monument Health Network, Inc.

  dba Monument Health Hot Springs Clinic

  • Multi-Specialty Clinic/Center
  • Hot Springs, SD
  • NPI 1588185268
  Medicare reassignment Care Compare group NPD
• Travis J Ptacek MD PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Rapid City, SD
  • NPI 1265113260
  Medicare reassignment Care Compare group NPD
• Avera McKennan

  dba Avera McKennan Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• City of Brookings

  dba Brookings Health System

  • Anesthesiology Physician
  • Brookings, SD
  • NPI 1932281029
  Medicare reassignment NPD
• City of Redfield

  dba Community Memorial Hospital

  • Critical Access Hospital
  • Redfield, SD
  • NPI 1548232747
  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  dba Pine Ridge IHS Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Bhpac-SNF PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Rapid City, SD
  • NPI 1770466161
  Medicare reassignment
• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment
• Avera McKennan

  dba Avera Interventional Radiology

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  dba Milbank Area Hospital/Avera Health

  • Critical Access Hospital
  • Milbank, SD
  • NPI 1548272818
  NPD
• City of Brookings

  dba Avera Medical Group a Department of Brookings Health System

  • Multi-Specialty Clinic/Center
  • Brookings, SD
  • NPI 1134558158
  NPD
• City of Brookings

  dba Brookings Health System Arlington Medical Center

  • Rural Health Clinic/Center
  • Arlington, SD
  • NPI 1902123581
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Monument Health Network, Inc

  dba Monument Health Custer Clinic

  • Critical Access Hospital
  • Custer, SD
  • NPI 1871560516
  Care Compare affiliation
• Regional Health Network, Inc.

  dba Hill City Clinic

  • Rural Health Clinic/Center
  • Hill City, SD
  • NPI 1609275908

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083611958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTN MSS",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017375",
            "telephone_number": "605-755-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 CHARLES ST",
            "city": "DEADWOOD",
            "state": "SD",
            "postal_code": "577321303",
            "telephone_number": "605-717-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PTACEK",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "16764",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "3859",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "460423930",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "460423930",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEBRASKA BCBS",
            "identifier": "06676",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0123937",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46042393011",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7988021",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "9214155",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monument Health Network, Inc. (Monument Health Lead-Deadwood Clinic)
• Monument Health Network, Inc. (Monuemnt Health Lead-Deadwood Hospital)
• Karen K Murphy, CNP
• Helen Beth Nichols, MNT
• Katherine L Oswald, MSW, CSW-PIP
• Megan Quinn, PT, DPT
• Regional Health (Lead-Deadwood Regional Medical Clinic)
• Regional Health Network Inc (Regional Home Medical Equipment)
• Regional Health Network Inc (Lead Deadwood Regional Hospital)
• Regional Health Network Inc. (Lead Deadwood Regional Hospital)

• Family Medicine Physician in Deadwood, SD
• Providers in Deadwood, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.