NPIMap

Individual provider Active NPI

Demetria L Glader, PA-C

  • Physician Assistant
  • Rapid City, SD
National Provider Identifier
1164435418
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0632 Issued in SD
Practice address
7220 Mount Rushmore Rd
Rapid City, SD 57702-8754
Phone
(605) 341-1414
Fax
(605) 341-7062
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 0632 SD Primary

Addresses

Primary practice location

7220 Mount Rushmore Rd
Rapid City, SD 57702-8754

Mailing address

PO Box 6850
Rapid City, SD 57709-6850
Phone (605) 341-1414

Other practice location 1

2820 Mount Rushmore Rd
Rapid City, SD 57701-5462
Phone (605) 342-3280

Other names 1

  • Demetria Lynn Raad Former name

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
I20061227000264 SD Practitioner - Physician Assistant 6305802661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Practice addresses (Care Compare)

216 Anamaria Dr
Rapid City, SD 57701-7366
Phone (605) 791-7777

4141 5TH St
Rapid City, SD 57701-6021
Phone (605) 341-1414

7220 Mount Rushmore Rd
Rapid City, SD 57702-8754
Phone (605) 737-9151

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.06 of 100Reported as group
Quality
99.26
Promoting interoperability
90
Improvement activities
40
Cost
92.59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Past Accepting new patients

Organizations & group practices 3

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 8

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164435418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6850",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577096850",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 MOUNT RUSHMORE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028754",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 Mount Rushmore Rd",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577015462",
            "country_code": "US",
            "telephone_number": "605-342-3280",
            "fax_number": "605-721-8407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLADER",
        "first_name": "DEMETRIA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEMETRIA",
            "last_name": "RAAD",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.