Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

RUSHMORE AMBULATORY SURGERY CENTER
NPI 1013968718
Clinic/Center - Ambulatory Surgical in Rapid City, SD

Q: What is Rushmore Ambulatory Surgery Center's NPI number?

The NPI number for Rushmore Ambulatory Surgery Center is 1013968718. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Black Hills Pediatric Dentistry Surgery Center.

Q: What is Rushmore Ambulatory Surgery Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since May 15, 2006

620 SHERIDAN LAKE RD STE 101, RAPID CITY, SD 57702(605) 718-9224(605) 718-9225 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 29, 2026, Aug 9, 2022 (2 updates tracked since 2022).

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About Rushmore Ambulatory Surgery Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUSHMORE AMBULATORY SURGERY CENTER (NPI 1013968718), doing business as Black Hills Pediatric Dentistry Surgery Center, is a healthcare organization registered as an ambulatory surgical in Rapid City, South Dakota and active in the NPI registry since May 2006. The organization lists Brent J Bradley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1013968718

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameRUSHMORE AMBULATORY SURGERY CENTER

Location Address620 SHERIDAN LAKE RD STE 101Rapid City, SD 57702-2490

Mailing Address620 Sheridan Lake Rd Ste 101Rapid City, SD 57702-2490 · (605) 718-9224 · Fax (605) 718-9225

Phone(605) 718-9224

Fax(605) 718-9225

Organization SubpartNo

Authorized OfficialBrent J BradleyCeo · (605) 341-3068

Enumeration DateMay 15, 2006

Last NPPES UpdateSeptember 29, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2026

✔ NPI 1013968718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

620 SHERIDAN LAKE RD STE 101, Rapid City, SD 57702

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Other Names 1

Doing Business AsBlack Hills Pediatric Dentistry Surgery Center

Other Identifiers 2

Other81022SD · Wellmark Blue Cross Blue Shield Of South Dakota

Medicaid5490450SD

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Wellmark of South Dakota, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rushmore Ambulatory Surgery Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateSouth DakotaEnrollment IDO20060628000096Non-DME Part B · Ambulatory Surgical CenterDue dateDecember 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rushmore Ambulatory Surgery Center's NPI number?

The NPI number for Rushmore Ambulatory Surgery Center is 1013968718. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Black Hills Pediatric Dentistry Surgery Center.

Where is Rushmore Ambulatory Surgery Center located?

Rushmore Ambulatory Surgery Center is located at 620 Sheridan Lake Rd Ste 101, Rapid City, SD 57702. The listed phone number is (605) 718-9224.

What is Rushmore Ambulatory Surgery Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Rushmore Ambulatory Surgery Center enrolled in Medicare?

Yes. Rushmore Ambulatory Surgery Center is registered in the Medicare PECOS enrollment system.

When is Rushmore Ambulatory Surgery Center's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (South Dakota, Ambulatory Surgical Center) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Rushmore Ambulatory Surgery Center accept?

Health plans from Wellmark of South Dakota, Inc. list Rushmore Ambulatory Surgery Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rushmore Ambulatory Surgery Center was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.