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DR. MARK J PTACEK M.D. NPI 1083611958


NPI Information

NPI: 1083611958
Provider Name: DR. MARK J PTACEK, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
71 CHARLES ST
DEADWOOD, SD
ZIP 57732
Phone: (605) 717-6431
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DR. Mark J Ptacek, M.D. is a family medicine in Deadwood, SD with 40 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Mark J Ptacek, M.D. NPI is 1083611958. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduation Year:1984

The provider's business location address is:

71 CHARLES ST
DEADWOOD, SD
ZIP 57732-303
Phone: (605) 717-6431

The NPI 1083611958 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/7/2005 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine16764NEBRASKANo
2207Q00000XFamily Medicine4872SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13859OTHERNEBRASKAMIDLANDS CHOICE
206676OTHERNEBRASKANEBRASKA BCBS
3460423930OTHERNEBRASKATRICARE
446042393011MEDICAIDNEBRASKA
59214155OTHERNEBRASKADAKOTA CARE
6460423930OTHERNEBRASKAHUMANA
77988021OTHERNEBRASKAAETNA
80123937OTHERNEBRASKAMEDICA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.