Individual provider Active NPI

Danny D Rickard, PA

  • Surgical Physician Assistant
  • Watertown, SD
National Provider Identifier
1902827918
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0555 Issued in SD
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-2630
Fax
(605) 882-0447
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0555 SD Primary

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

PO Box 170
Watertown, SD 57201-0170
Phone (605) 882-2630

Other identifiers 4

IdentifierTypeStateIssuer
6825300MedicaidSD
249T3RIOtherMNBCBS
4995766OtherSDBCBS
640825700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040426001383 SD Practitioner - Physician Assistant 1355231200
I20160427001292 ND Practitioner - Physician Assistant 1355231200 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0555SDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oakes Community Hospital CurrentSince Mar 1, 2016 Accepting new patients
Aberdeen Asthma & Allergy PC Past Accepting new patients

Locations

4784 Amber Valley Pkwy S
Fargo, ND 58104

1200 N 7th St
Oakes, ND 58474
Phone (701) 742-3291

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1902827918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572010170",
            "telephone_number": "605-882-2630",
            "fax_number": "605-882-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-2630",
            "fax_number": "605-882-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKARD",
        "first_name": "DANNY",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SD",
            "license": "0555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6825300",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "249T3RI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4995766",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640825700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.