NPIMap

Individual provider Active NPI

Sara L Hartsaw, MD

  • Surgery Physician
  • Gillette, WY
National Provider Identifier
1881691905
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4519A Issued in WY
Practice address
3100 W Lakeway Rd Ste 1
Gillette, WY 82718-6373
Phone
(307) 682-7555
Fax
(307) 687-7243
NPI assigned
Jul 5, 2005
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4519A WY Primary

Addresses

Primary practice location

3100 W Lakeway Rd Ste 1
Gillette, WY 82718-6373

Mailing address

PO Box 1272
Gillette, WY 82717-1272
Phone (307) 682-7555

Other identifiers 1

IdentifierTypeStateIssuer
104231900MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20100928001292 WY Practitioner - General SurgeryPractitioner - Thoracic Surgery 4688657075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Thoracic Surgery
Education
Creighton University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3100 W Lakeway Rd
Suite 1
Gillette, WY 82718-6373
Phone (307) 682-7555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy110
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell County Hospital District PastSince Nov 1, 2010 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Campbell County HealthGillette, WY, CCN 53S002 Hospital Corporate Director Nov 1, 2010
The Legacy Living and Rehabilitation CenterGillette, WY, CCN 535022 Skilled nursing facility Managing Control - Governing Body Dec 9, 2022
Campbell County Memorial Hospital Home HealthGillette, WY, CCN 537035 Home health agency Corporate Officer Nov 1, 2010
The Hospice of Campbell County Memorial HospitalGillette, WY, CCN 531519 Hospice Corporate Officer Dec 9, 2010

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1881691905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1272",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827171272",
            "telephone_number": "307-682-7555",
            "fax_number": "307-687-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W LAKEWAY RD STE 1",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186373",
            "telephone_number": "307-682-7555",
            "fax_number": "307-687-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTSAW",
        "first_name": "SARA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WY",
            "license": "4519A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104231900",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.