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DR. TRICIA BIRDWELL M.D.
NPI 1609974294
Family Medicine in Rapid City, SD

Active since September 20, 2006Opted out of Medicare · through Mar 16, 2028
1760 CENTRE ST STE 1, RAPID CITY, SD 57703(605) 600-2250(605) 653-1573 Get Directions Write a Review

NPPES record last updated: May 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 17, 2023, Oct 26, 2022, Jul 14, 2022 and 1 more (4 updates tracked since 2017).

About Dr. Tricia Birdwell M.d. NPPES

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

DR. TRICIA BIRDWELL M.D. (NPI 1609974294) is an individual family medicine provider in Rapid City, South Dakota, licensed in South Dakota (12858) and active in the NPI registry since September 2006. She has opted out of Medicare through March 16, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1609974294
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. TRICIA BIRDWELLCredential: M.D.
Location Address1760 CENTRE ST STE 1Rapid City, SD 57703-4035
Mailing Address1760 Centre St Ste 1Rapid City, SD 57703-4035 · (605) 600-2250 · Fax (605) 653-1573
Phone(605) 600-2250
Fax(605) 653-1573
Sole ProprietorYes
Enumeration DateSeptember 20, 2006
Last NPPES UpdateMay 28, 20244 updates tracked since enumeration
NPPES CertifiedMay 28, 2024
✔ NPI 1609974294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in SD · 12858✔ Licensed in ID · M-15867✔ Licensed in CA · A89563
Definition
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.
1760 CENTRE ST STE 1, Rapid City, SD 57703
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Tricia Birdwell M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 16, 2022 through March 16, 2028.

Opt-Out Effective DateMarch 16, 2022
Opt-Out In Effect ThroughMarch 16, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57703 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.21 typical visit price
range $55.52 – $167.23
Typical copayment $21.30 (range $13.88 – $41.80)
Most-billed visit code 99203
Established Patient
$97.88 typical visit price
range $18.08 – $137.08
Typical copayment $24.47 (range $4.52 – $34.27)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%4,422 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
60%550 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%714 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
98%1,468 patients5/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
20%1,468 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
5%1,468 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
16%1,468 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers13 claims30 services$5.80 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Tricia Birdwell's NPI number?

The NPI number for Tricia Birdwell is 1609974294. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Tricia Birdwell located?

Tricia Birdwell practices at 1760 Centre St Ste 1, Rapid City, SD 57703. The listed phone number is (605) 600-2250.

What is Tricia Birdwell's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Tricia Birdwell enrolled in Medicare?

No. Tricia Birdwell has opted out of Medicare through March 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Tricia Birdwell was last updated on May 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.