Travis John Ptacek, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12126 Issued in SD

Practice address

620 John Paul Jones Circle
Naval Medical Center Portsmouth
Portsmouth, VA 23708-2197

Phone

(757) 953-5257

NPI assigned

Apr 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD, ND, GA, NC, MT5 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 5

Specialty

Family PracticeAlso: Geriatric Medicine

Education

Nebraska College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Travis J Ptacek MD PLLC 10 clinicians

Monument Health Network Inc 163 clinicians

Madison Community Hospital 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stillwater Hospice of South Dakota Hospice, Rapid City, SD, CCN 431520
• Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
• Monument Health Custer Hospital Hospital, Custer, SD, CCN 431323
• Monument Health Spearfish Hospital Hospital, Spearfish, SD, CCN 430048
• Fall River Hospital - Cah Hospital, Hot Springs, SD, CCN 431322
• Madison Regional Health System Hospital, Madison, SD, CCN 431300
• Spearfish Canyon Healthcare Nursing home, Spearfish, SD, CCN 435043
• Fountain Springs Healthcare Nursing home, Rapid City, SD, CCN 435110
• Rolling Hills Healthcare Nursing home, Belle Fourche, SD, CCN 435035
• Avantara Mountain View Nursing home, Rapid City, SD, CCN 435040
• Avantara North Nursing home, Rapid City, SD, CCN 435064

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

All facility ownership & control disclosures 6

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

Owned or controlled facilities with NPI records 6

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

• Arrowhead SD Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Rapid City, SD
  • NPI 1881250397

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Fountain Springs SNF Operations, LLC

  • Skilled Nursing Facility
  • Rapid City, SD
  • NPI 1174237432

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Grace of the Pines Hospice LLC

  • Community Based Hospice Care Agency
  • Hot Springs, SD
  • NPI 1518338227

  Contracted Managing Employee

  CMS ownership
• Mountain View SD Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Rapid City, SD
  • NPI 1093371155

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• RC North SD Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Rapid City, SD
  • NPI 1427614585

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Saint Cloud SD Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Rapid City, SD
  • NPI 1770149833

  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 and National Provider Directory roles.

• Travis J Ptacek MD PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Rapid City, SD
  • NPI 1265113260

  MT, SD

  Medicare reassignment Care Compare group NPD Authorized official
• Madison Community Hospital

  • Critical Access Hospital
  • Madison, SD
  • NPI 1588644058

  SD

  Medicare reassignment Care Compare group NPD
• Monument Health Network, Inc

  • Critical Access Hospital
  • Custer, SD
  • NPI 1871560516

  SD

  Medicare reassignment Care Compare group NPD
• Monument Health Network, Inc.

  • Multi-Specialty Clinic/Center
  • Hot Springs, SD
  • NPI 1588185268

  SD

  Medicare reassignment Care Compare group NPD
• Bhpac-SNF PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Rapid City, SD
  • NPI 1770466161

  SD

  Medicare reassignment Authorized official
• Careconnectmd South Dakota PC

  • General Practice Physician
  • Sioux Falls, SD
  • NPI 1306527866

  SD

  Medicare reassignment NPD
• City of Brookings

  • Anesthesiology Physician
  • Brookings, SD
  • NPI 1932281029

  SD

  Medicare reassignment NPD
• Houston County Emergency Group, LLC

  • Emergency Medicine Physician
  • Warner Robins, GA
  • NPI 1013338193

  GA

  Medicare reassignment NPD
• Huron Regional Medical Center Inc

  • Critical Access Hospital
  • Huron, SD
  • NPI 1154312429

  SD

  Medicare reassignment NPD
• Lutheran Charity Association

  • Critical Access Hospital
  • Jamestown, ND
  • NPI 1548256753

  ND

  Medicare reassignment NPD
• Lutheran Charity Association

  • Emergency Medicine Physician
  • Jamestown, ND
  • NPI 1821044652

  ND

  Medicare reassignment NPD
• Monument Health Rapid City Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463

  SD

  Medicare reassignment NPD

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

• Belle Fourche Nursing and Rehab Center LLC

  • Skilled Nursing Facility
  • Belle Fourche, SD
  • NPI 1841761210

  Nursing home

  Care Compare affiliation
• Fall River Health Services

  • Critical Access Hospital
  • Hot Springs, SD
  • NPI 1679544555

  Hospital

  Care Compare affiliation
• Fountain Springs SNF Operations, LLC

  • Skilled Nursing Facility
  • Rapid City, SD
  • NPI 1174237432

  Nursing home

  Care Compare affiliation
• Grace of the Pines Hospice LLC

  • Community Based Hospice Care Agency
  • Hot Springs, SD
  • NPI 1518338227

  Hospice

  Care Compare affiliation
• Madison Community Hospital

  • Critical Access Hospital
  • Madison, SD
  • NPI 1588644058

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc

  • Critical Access Hospital
  • Custer, SD
  • NPI 1871560516

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • General Acute Care Hospital
  • Spearfish, SD
  • NPI 1033183942

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • Dermatology Physician
  • Spearfish, SD
  • NPI 1477932390

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • General Acute Care Hospital
  • Spearfish, SD
  • NPI 1548648264

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • General Acute Care Hospital
  • Spearfish, SD
  • NPI 1720491137

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • Orthopaedic Surgery Physician
  • Spearfish, SD
  • NPI 1811375496

  Hospital

  Care Compare affiliation
• Monument Health Network, Inc.

  • Multi-Specialty Clinic/Center
  • Spearfish, SD
  • NPI 1902284581

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1477819944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017375",
            "telephone_number": "605-755-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIRCLE",
            "address_2": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082197",
            "telephone_number": "757-953-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PTACEK",
        "first_name": "TRAVIS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.