ETHAN DAVID BURDMAN, PA-C, MPAS — NPI 1710130190 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical in GETTYSBURG, SD)

CMS-1500 Box 24J / 33a • NPI

1710130190

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363AM0700X (CMS 97)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical

Box 32 Service Location & ZIP+4

608 E GARFIELD AVE, GETTYSBURG, SD, 57442-1325

✓ 9-Digit EDI 837 ZIP+4 (57442-1325)

Practice Phone & Referral Fax

(605) 765-2273

Fax: (605) 765-3212

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1710130190 (ETHAN DAVID BURDMAN, PA-C, MPAS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1710130190` (NPI-1 Individual Practitioner)
Provider / Legal Name	ETHAN DAVID BURDMAN, PA-C, MPAS
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical NUCC Code: `363AM0700X` (Physician Assistant, Medical)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	608 E GARFIELD AVE, GETTYSBURG, SD, 57442-1325
Practice Telephone / Fax	Tel: (605) 765-2273 \| Fax: (605) 765-3212
Administrative Mailing Address	1515 VILLAGE DR, COTTAGE GROVE, OR, 97424-9700
Enumeration & Last Sync	Enumerated: 2008-10-29 \| CMS Record Updated: 2025-09-10

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

608 E GARFIELD AVE, GETTYSBURG, SD, 57442-1325

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Plain-English Taxonomy & CMS Crosswalk (363AM0700X)

What Does Taxonomy Code 363AM0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AM0700X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 97 (Physician Assistant)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Physician Assistant, Medical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ETHAN DAVID BURDMAN, PA-C, MPAS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363AM0700X` — Physician Assistant, Medical Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical	State: SD \| License: `0692` \| Primary: Yes (Primary)
`363A00000X` — Physician Assistant Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant	State: OR \| License: `PA164996` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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ETHAN DAVID BURDMAN, PA-C, MPAS (NPI #1710130190)