Organization Active NPI

Black Hills Pediatrics, LLP

  • Pediatrics Physician
  • Rapid City, SD
National Provider Identifier
1639229727
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BLACK HILLS PEDIATRICS, LLP
Practice address
2905 5TH St
Rapid City, SD 57701-7316
Phone
(605) 341-7337
Fax
(605) 341-2447
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Dean Hass
Title
Business Administrator
Phone
(605) 341-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2905 5TH St
Rapid City, SD 57701-7316

Mailing address

2905 5TH St
Rapid City, SD 57701-7316
Phone (605) 341-7337

Other names 1

  • Black Hills Pediatrics and Neonatology, LLP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041110000461 SD Part B Supplier - Clinic/Group Practice 4486617420 Receives reassigned benefits from 9 practitioners
Practice locations: Rapid City, SD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D0407918Black Hills Pediatrics LLP2905 South 5TH St, Rapid City, SD 57701ComplianceJan 18, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1639229727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017316",
            "telephone_number": "605-341-7337",
            "fax_number": "605-341-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017316",
            "telephone_number": "605-341-7337",
            "fax_number": "605-341-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK HILLS PEDIATRICS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "HASS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "605-341-7337"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Hills Pediatrics and Neonatology, LLP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.