Tricia Birdwell, M.D.
Individual provider Active NPI Family Medicine Physician · Rapid City, SD
NPI 1609974294 · NPPES record last updated May 28, 2024
Key facts
- NPI
- 1609974294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 12858 (SD)
- Practice address
- 1760 Centre St Ste 1
Rapid City, SD 57703-4035 - Phone
- (605) 600-2250
- Fax
- (605) 653-1573
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 16, 2022 through Mar 16, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-15867 | ID | MD | Family Medicine Physician |
| 12858 | SD | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M-15867 | ID | |
| Family Medicine Physician | 207Q00000X | A89563 | CA | |
| Family Medicine Physician | 207Q00000X | 12858 | SD | Yes |
Addresses
Primary practice location
1760 Centre St Ste 1
Rapid City, SD 57703-4035
Mailing address
1760 Centre St Ste 1
Rapid City, SD 57703-4035
Phone (605) 600-2250
Other providers in Rapid City, SD
- Tina Billings
- Abbygail Bingham
- Fredric M. Birch
- Eugene Raymond Birchem
- Kelli Jo Birdsall
- Julie Birner
- Bethany Grace Bishop
- Amid Bitar
- Karetha Pearl Bittorf
- Julia Marie Bitz
All providers in Rapid City, SD · Family Medicine Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.