Southern Hills Family Medicine, Prof Llc - Medicare Primary Care in Custer, SD

Southern Hills Family Medicine, Prof Llc is a medicare enrolled primary clinic (Family Medicine) in Custer, South Dakota. The current practice location for Southern Hills Family Medicine, Prof Llc is 1369 Montgomery St, Custer, South Dakota. For appointments, you can reach them via phone at (605) 673-3900. The mailing address for Southern Hills Family Medicine, Prof Llc is 1369 Montgomery St, Custer, South Dakota and phone number is (605) 673-3900.

Southern Hills Family Medicine, Prof Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1457013963. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (605) 673-3900.

Contact Information

Southern Hills Family Medicine, Prof Llc
1369 Montgomery St
Custer
SD 57730-8246
(605) 673-3900
Not Available

Primary Care Clinic Profile

Full NameSouthern Hills Family Medicine, Prof Llc
SpecialityFamily Medicine
Location1369 Montgomery St, Custer, South Dakota
Authorized Official Name and PositionBrandyn A Tarap (SOLE MEMBER)
Authorized Official Contact6056733900
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Southern Hills Family Medicine, Prof Llc
1369 Montgomery St
Custer
SD 57730-8246

Ph: (605) 673-3900
Southern Hills Family Medicine, Prof Llc
1369 Montgomery St
Custer
SD 57730-8246

Ph: (605) 673-3900

NPI Details:

NPI Number1457013963
Provider Enumeration Date10/12/2021
Last Update Date09/07/2023

Medicare PECOS Information:

Medicare PECOS PAC ID8224427968
Medicare Enrollment IDO20211117003207

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Medical Identifiers

Medical identifiers for Southern Hills Family Medicine, Prof Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457013963NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Southern Hills Family Medicine, Prof Llc acts as a billing entity for following providers:
Provider NameBrenda Vandewater
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669847067
PECOS PAC ID: 7315236775
Enrollment ID: I20160525001313

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Provider NameBrandyn Tarap
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1619316585
PECOS PAC ID: 2264720598
Enrollment ID: I20161019001100

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Family Medicine in Custer, SD

Custer Regional Medical Clinic
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1041 Montgomery St, Custer, SD 57730
Phone: 605-673-4150    
Regional Health Physicians Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1041 Montgomery St, Custer, SD 57730
Phone: 605-673-4150    
Custer Regional Clinic
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1041 Montgomery St, Custer, SD 57730
Phone: 605-673-4150    

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