NPIMap

Individual provider Active NPI

Rebecca L Stafford, PA-C

  • Physician Assistant
  • Rapid City, SD
National Provider Identifier
1578884847
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0792 Issued in SD
Practice address
353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone
(605) 755-8222
Fax
(605) 755-4203
NPI assigned
Jun 21, 2010
Last updated
Mar 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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 0792 SD Primary

Addresses

Primary practice location

353 Fairmont Blvd
Rapid City, SD 57701-7375

Mailing address

PO Box 912882
Denver, CO 80291-2882
Phone (866) 765-0909

Other practice location 1

4141 5th St
Rapid City, SD 57701-6021
Phone (605) 341-2424

Other identifiers 4

IdentifierTypeStateIssuer
1578884847MedicaidSD
1578884847MedicaidWY
1471560MedicaidND
1578884847MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120120000760 SD Practitioner - Physician Assistant 9739356452 Reassigns benefits to 3 organizations
I20251020001751 NE Practitioner - Physician Assistant 9739356452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

677 Cathedral Dr
Suite 310
Rapid City, SD 57701-6018
Phone (605) 755-6720

825 Centennial Dr
Chadron, NE 69337-9400
Phone 30843255869400

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
Monument Health Rapid City Hospital Inc CurrentSince Dec 2, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Oct 1, 2025 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Dec 2, 2024 Accepting new patients
Regional Health Physicians Inc Past Accepting new patients
Regional Health Physicians Inc Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

825 Centennial Dr
Chadron, NE 69337
Phone (308) 432-4441

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

640 Flormann St
Ste 300
Rapid City, SD 57701
Phone (605) 718-3300

Interoperability endpoints

  • Direct secure messaging: rstafford.12532@regionalhealth.sdhealthlink.net

Organizations & group practices 8

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1578884847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912882",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912882",
            "telephone_number": "866-765-0909",
            "fax_number": "855-856-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017375",
            "telephone_number": "605-755-8222",
            "fax_number": "605-755-4203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4141 5th St",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577016021",
            "country_code": "US",
            "telephone_number": "605-341-2424",
            "fax_number": "605-341-4547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578884847",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578884847",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1471560",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578884847",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.