NPIMap

Individual provider Active NPI

Candace R Fetzer, MD

  • Hospitalist Physician
  • Rapid City, SD
National Provider Identifier
1831146596
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
7753 Issued in SD
Practice address
353 Fairmont Blvd.
Rapid City, SD 57701
Phone
(605) 719-1000
NPI assigned
May 28, 2006
Last updated
Jan 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 7753 SD Primary

Addresses

Primary practice location

353 Fairmont Blvd.
Rapid City, SD 57701

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100918000195 SD Practitioner - HospitalistPractitioner - Internal Medicine 0345131587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Washington School of Medicine, 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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7753SDMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Jul 20, 2010 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Rapid City Regional Hospital Inc CurrentSince Jul 20, 2010 Accepting new patients
Kalispell Medical Offices Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: cfetzer.8085@regionalhealth.sdhealthlink.net

Organizations & group practices 4

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1831146596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "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": "57701",
            "telephone_number": "605-719-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETZER",
        "first_name": "CANDACE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SD",
            "license": "7753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.