Kaitlan Elise Brosnahan, CNP
Individual provider Active NPI Nurse Practitioner · Rapid City, SD
NPI 1639766843 · NPPES record last updated Dec 22, 2020
Key facts
- NPI
- 1639766843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- CP001914 (SD)
- Practice address
- 353 Fairmont Blvd
Rapid City, SD 57701-7375 - Phone
- (605) 755-8222
- NPI assigned
- Dec 22, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Great Plains Tribal Chairmen'S Health Board
Practice addresses (Care Compare)
3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone 60535525002356
Hospital & facility affiliations
- Monument Health Rapid City Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.16 of 100
- Quality
- 99.03
- Improvement activities
- 40
- Cost
- 78.09
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260515002002 | TX | Practitioner - Nurse Practitioner | 5799198636 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP001914 | SD | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rapid City Emergency Services PA | Nurse Practitioner | Current |
Accepting new patients |
Locations
353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CP001914 | SD | Yes |
Addresses
Primary practice location
353 Fairmont Blvd
Rapid City, SD 57701-7375
Mailing address
3711 Meadowbrook Dr
Rapid City, SD 57702-0546
Phone (605) 645-8479
Other providers in Rapid City, SD
- Cinthia Brockhoft
- Thomas Brockhoft
- Tyler James Broghammer
- Mary Ann Brooks
- Stephanie Brooks
- Laura Broten
- Amber Shelly Rose Brown
- Douglas Thorburn Brown
- Ezzard Smiley Zoe Brown
- Makayla Brown
All providers in Rapid City, SD · Nurse Practitioner 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 Dec 22, 2020. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.