MEDICARE: MIDWEST HEART AND VASCULAR ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1144027996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST HEART AND VASCULAR ASSOCIATES

Provider Business Mailing Address
First Line	:	2805 5TH ST STE 200
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-7386
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2805 5TH ST STE 200
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-7386
Country	:	US
Telephone Number	:	605-646-5715
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BHASKAR PURUSHOTTAM
Credential	:	MD
Telephone Number	:	605-755-4300

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	03/26/2025

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