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GREAT PLAINS DERMATOLOGY, P.A.
NPI 1740380963
Dermatology in Hays, KS

Active since September 25, 2006CLIA 17D0884252 · Certificate of Compliance
2708 STERNBERG DR, HAYS, KS 67601(785) 625-7546(785) 625-7598 Get Directions Write a Review

NPPES record last updated: February 25, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Great Plains Dermatology, P.a. NPPES

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

GREAT PLAINS DERMATOLOGY, P.A. (NPI 1740380963) is a healthcare organization registered as a dermatology in Hays, Kansas and active in the NPI registry since September 2006. The organization holds a CLIA Certificate of Compliance certificate valid through November 30, 2026 and lists Donald Kenneth Tillman, President, as its authorized official.

NPPES Registry Identity

NPI1740380963
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameGREAT PLAINS DERMATOLOGY, P.A.
Location Address2708 STERNBERG DRHays, KS 67601-1922
Mailing Address2708 Sternberg DrHays, KS 67601 · (785) 625-7546 · Fax (785) 625-7598
Phone(785) 625-7546
Fax(785) 625-7598
Organization SubpartNo
Authorized OfficialDonald Kenneth TillmanPresident · (785) 625-7546
Enumeration DateSeptember 25, 2006
Last NPPES UpdateFebruary 25, 2011
✔ NPI 1740380963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in KS · 0523958
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
2708 STERNBERG DR, Hays, KS 67601
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Other Identifiers 2

Medicare UPINE97022KS
Medicare ID-Type Unspecified016813KS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Great Plains Dermatology, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Great Plains Dermatology, P.A., which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Julie Brull, ARNP-C
Nurse Practitioner
NPI 1538278429
2708 STERNBERG DR
Hays, KS 67601
(785) 625-7546
✔ PECOS✔ Accepts MedicareSame address
Donald Tillman, D.O.
Dermatology
NPI 1821198037
2708 STERNBERG DR
Hays, KS 67601
(785) 625-7546
✔ PECOS✔ Accepts MedicareSame address
Nicole Hibbs, D.O.
Dermatology
NPI 1871937250
2708 STERNBERG DR
Hays, KS 67601
(785) 625-7546
✔ PECOS✔ Accepts MedicareSame address
Madysen Weigel, APRN
Nurse Practitioner
NPI 1295492908
2708 STERNBERG DR
Hays, KS 67601
(785) 625-7546
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 17D0884252

Great Plains Dermatology, PA · Hays, KS
Active · expires Nov 30, 2026
CLIA Number17D0884252
Laboratory TypePhysician Office
Certificate Effective DateAugust 1, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorDonald K. Tillman Jr
Laboratory Phone(785) 625-7546
Laboratory LocationGreat Plains Dermatology, PA2708 Sternberg Dr, Hays, KS 67601
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Great Plains Dermatology, P.A.'s NPI number?

The NPI number for Great Plains Dermatology, P.A. is 1740380963. It was assigned to this organization in the NPPES registry on September 25, 2006.

Where is Great Plains Dermatology, P.A. located?

Great Plains Dermatology, P.A. is located at 2708 Sternberg Dr, Hays, KS 67601. The listed phone number is (785) 625-7546.

What is Great Plains Dermatology, P.A.'s specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Great Plains Dermatology, P.A. enrolled in Medicare?

Yes. Great Plains Dermatology, P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Great Plains Dermatology, P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Great Plains Dermatology, P.A., in Dermatology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Great Plains Dermatology, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 17D0884252) is associated with this NPI, valid through November 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Great Plains Dermatology, P.A. accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Great Plains Dermatology, P.A. 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 Great Plains Dermatology, P.A. was last updated on February 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.