NPIMap

Individual provider Active NPI

Trevor Ryan Anderson, MD

  • Physical Medicine & Rehabilitation Physician
  • Rapid City, SD
National Provider Identifier
1386838324
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
8543 Issued in SD
Practice address
4141 5TH St
Rapid City, SD 57701-6021
Phone
(605) 341-1414
Fax
(605) 341-7062
NPI assigned
Sep 4, 2007
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 8543 SD Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 8543 SD

Addresses

Primary practice location

4141 5TH St
Rapid City, SD 57701-6021

Mailing address

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

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
I20121113000104 SD Practitioner - Physical Medicine and Rehabilitation 4486826864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Sanford School of Medicine of University of South Dakota, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8543SDMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Orthopedic & Spine Center, Inc. CurrentSince Dec 1, 2023 Accepting new patients
Neuro Surgical & Spinal Surgery Associates, P.C. PastSince Oct 1, 2012 Accepting new patients

Locations

4141 5th St
Rapid City, SD 57701
Phone (605) 341-2424

7220 Mount Rushmore Rd
Rapid City, SD 57702
Phone (605) 737-9144

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71180

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1386838324",
    "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": "4141 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016021",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TREVOR",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SD",
            "license": "8543",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "SD",
            "license": "8543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.