NPIMap

Individual provider Active NPI

Andrea Juhl Hansen

  • Physician Assistant
  • Rapid City, SD
National Provider Identifier
1154634673
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0778 Issued in SD
Practice address
4141 5TH St
Rapid City, SD 57701-6021
Phone
(605) 791-0602
Fax
(605) 791-0978
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0778 SD Primary

Addresses

Primary practice location

4141 5TH St
Rapid City, SD 57701-6021

Mailing address

PO Box 2654
Rapid City, SD 57709-2654
Phone (605) 791-0602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110513000033 SD Practitioner - Physician Assistant 5092900084 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis J Ptacek MD PLLCGroup PAC ID 1658725692, 10 clinicians

Practice addresses (Care Compare)

2000 Wesleyan Blvd
Rapid City, SD 57702-9340
Phone (317) 370-2013

2500 Arrowhead Dr
Rapid City, SD 57702-4225
Phone (317) 370-2013

Hospital & facility affiliations

  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as apm
Quality
57.34
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
64.94 of 100Reported as group
Quality
14.29
Promoting interoperability
97
Improvement activities
40
Cost
71.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0778SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Surgical Hospital, LLC CurrentSince Aug 15, 2016 Accepting new patients
Bhpac-SNF PLLC CurrentSince Dec 25, 2025 Accepting new patients

Locations

1065 Montgomery St
Custer, SD 57730
Phone (605) 343-4958

302 Saint Cloud St
Rapid City, SD 57701
Phone (605) 343-4738

1868 Lombardy Dr
Rapid City, SD 57703
Phone (605) 721-4900

916 Mountain View Rd
Rapid City, SD 57702
Phone (605) 343-4958

216 Anamaria Dr
Rapid City, SD 57701
Phone (605) 388-9440

2500 Arrowhead Dr
Rapid City, SD 57702
Phone (317) 370-2013

2000 Wesleyan Blvd
Rapid City, SD 57702
Phone (605) 343-3555

1620 N 7th St
Rapid City, SD 57701
Phone (605) 343-4958

1020 N 10th St
Spearfish, SD 57783
Phone (605) 642-2716

Organizations & group practices 4

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

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1154634673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2654",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577092654",
            "telephone_number": "605-791-0602",
            "fax_number": "605-791-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016021",
            "telephone_number": "605-791-0602",
            "fax_number": "605-791-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "ANDREA",
        "middle_name": "JUHL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.