| Travis J Ptacek Md Pllc | |
|
529 Kansas City St Ste 203 Rapid City SD 57701-3693 | |
| (605) 223-0011 | |
| Not Available |
| Full Name | Travis J Ptacek Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 529 Kansas City St Ste 203, Rapid City, South Dakota |
| Authorized Official Name and Position | Travis Ptacek (PHYSICIAN) |
| Authorized Official Contact | 6052230011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Travis J Ptacek Md Pllc 529 Kansas City St Ste 203 Rapid City SD 57701-3693 Ph: () - | Travis J Ptacek Md Pllc 529 Kansas City St Ste 203 Rapid City SD 57701-3693 Ph: (605) 223-0011 |
| NPI Number | 1265113260 |
|---|---|
| Provider Enumeration Date | 07/31/2023 |
| Last Update Date | 08/11/2023 |
| Medicare PECOS PAC ID | 1658725692 |
|---|---|
| Medicare Enrollment ID | O20230926001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265113260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeanie M Lembke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922054279 PECOS PAC ID: 8325189715 Enrollment ID: I20100107000339 |
| Provider Name | Ashley E Brunmaier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336684372 PECOS PAC ID: 3173807401 Enrollment ID: I20170303001167 |
| Provider Name | Travis J. Ptacek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477819944 PECOS PAC ID: 5092087486 Enrollment ID: I20200915002674 |
| Provider Name | Patrick D Flanigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083245393 PECOS PAC ID: 9133557572 Enrollment ID: I20210112002807 |
| Provider Name | Mckaela Aghbashian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407534332 PECOS PAC ID: 3971950304 Enrollment ID: I20231107002512 |
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