NPIMap

Individual provider Active NPI

Tara L Carlson, PA-C

  • Physician Assistant
  • Sturgis, SD
National Provider Identifier
1215978382
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0604 Issued in SD
Practice address
890 Lazelle St
Sturgis, SD 57785
Phone
(605) 720-2600
Fax
(605) 720-2611
NPI assigned
Jun 9, 2006
Last updated
Feb 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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 0604 SD Primary

Addresses

Primary practice location

890 Lazelle St
Sturgis, SD 57785

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

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
I20051101001238 SD Practitioner - Physician Assistant 1658398276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1303 N Lacrosse St
Rapid City, SD 57701-6956
Phone (605) 755-6600

2116 Jackson Blvd
Rapid City, SD 57702-3495
Phone (605) 755-3900

2526 Elderberry Blvd
Rapid City, SD 57703-6589
Phone (605) 755-2273

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

375 Berky Dr
Box Elder, SD 57719-8060
Phone (605) 755-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0604SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Oct 13, 2021 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Oct 13, 2021 Accepting new patients
Monument Health Network, Inc. CurrentSince Jan 17, 2015 Accepting new patients
Regional Health Physicians Inc Past Accepting new patients
Queen City Regional Medical Clinic Physician Assistant Past Accepting new patients
Regional Health Physicians Inc Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

1420 N 10th St
Spearfish, SD 57783
Phone (605) 642-8414

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536

2140 Junction Ave
Sturgis, SD 57785
Phone (605) 720-2400

Interoperability endpoints

  • Direct secure messaging: tcarlson.7832@regionalhealth.sdhealthlink.net

Organizations & group practices 7

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.

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1215978382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 LAZELLE ST",
            "city": "STURGIS",
            "state": "SD",
            "postal_code": "57785",
            "telephone_number": "605-720-2600",
            "fax_number": "605-720-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgis, SD

Sources for this page

Verify at the official NPI Registry.