Donald B Tardif, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

246 Issued in WY

Practice address

501 S Burma Ave
Gillette, WY 82716-3426

Phone

(307) 464-0413

Fax

(307) 688-7965

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell County Hospital DistrictGroup PAC ID 2860392529, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Campbell County Health Hospital, Gillette, WY, CCN 530002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Campbell County Hospital District

  • Internal Medicine Physician
  • Gillette, WY
  • NPI 1710098868
  Medicare reassignment Care Compare group
• Campbell County Hospital District

  • Land Ambulance
  • Gillette, WY
  • NPI 1083278501
  NPD
• Campbell County Hospital District

  • Family Medicine Physician
  • Hulett, WY
  • NPI 1750047031
  NPD
• Campbell County Hospital District

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gillette, WY
  • NPI 1881730141
  NPD
• Campbell County Hospital District

  • Community/Retail Pharmacy
  • Gillette, WY
  • NPI 1992874218
  NPD
• Campbell County Hospital District

  • Skilled Nursing Facility
  • Gillette, WY
  • NPI 1376620989
  NPD (past)
• Pain Treatment Center of Wyoming, LLC

  • Interventional Pain Medicine Physician
  • Cheyenne, WY
  • NPI 1598762965
  NPD (past)

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

• Campbell County Hospital District

  • General Acute Care Hospital
  • Gillette, WY
  • NPI 1487638417
  Care Compare affiliation
• Campbell County Hospital District

  • Ambulatory Surgical Clinic/Center
  • Gillette, WY
  • NPI 1780738153

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1891887170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3011",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827173011",
            "telephone_number": "307-464-0413",
            "fax_number": "307-688-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BURMA AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163426",
            "telephone_number": "307-464-0413",
            "fax_number": "307-688-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARDIF",
        "first_name": "DONALD",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "246",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WY",
            "license": "246",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cchwyo@cchwyo.sdhealthlink.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "501 S Burma Ave",
            "city": "Gillette",
            "state": "WY",
            "country_code": "US",
            "postal_code": "827163426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Alicia M. Teeter, MS, LPC, LCPC, LPCC
• Tendercare LLC

• Physician Assistant in Gillette, WY
• Providers in Gillette, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.
• 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.