Ethan David Burdman, PA-C, MPAS

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0692 Issued in SD

Practice address

608 E Garfield Ave
Gettysburg, SD 57442-1325

Phone

(605) 765-2273

Fax

(605) 765-3212

NPI assigned

Oct 29, 2008

Last updated

Sep 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eburdman265392@direct.peacehealth.org

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.

• Eugene Emergency Physicians PC

  • Emergency Medicine Physician
  • Eugene, OR
  • NPI 1831133677
  Medicare reassignment
• Peacehealth

  dba Cottage Grove Community Medical CT

  • Critical Access Hospital
  • Cottage Grove, OR
  • NPI 1902892391
  Medicare reassignment
• Peacehealth Medical Group Cottage Grove

  • Multi-Specialty Clinic/Center
  • Creswell, OR
  • NPI 1780631267
  NPD

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1710130190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 VILLAGE DR",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974249700",
            "telephone_number": "541-767-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E GARFIELD AVE",
            "city": "GETTYSBURG",
            "state": "SD",
            "postal_code": "574421325",
            "telephone_number": "605-765-2273",
            "fax_number": "605-765-3212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "OR",
            "postal_code": "974249700",
            "country_code": "US",
            "telephone_number": "541-767-5222",
            "fax_number": "541-767-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDMAN",
        "first_name": "ETHAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-29",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA164996",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": "0692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH DAKOTA STATE LICENSE",
            "identifier": "0692",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diana Latinow DDS, MSD, PC

• Medical Physician Assistant in Gettysburg, SD
• Providers in Gettysburg, SD by specialty
• Medical Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.