PROVIDENCE HEALTH & SERVICES MT
NPI 1124268982
Internal Medicine - Obesity Medicine in Missoula, MT

Q: What is Providence Health & Services Mt's NPI number?

The NPI number for Providence Health & Services Mt is 1124268982. It was assigned to this organization in the NPPES registry on March 5, 2009. The provider is doing business as Providence Medical Group Montana. The provider is also known as PMG MT Bariatric Services.

Q: What is Providence Health & Services Mt's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Obesity Medicine, with taxonomy code 207RB0002X.

Active since March 05, 2009

500 W BROADWAY ST, 4TH FLOOR, MISSOULA, MT 59802(406) 329-5866 Get Directions Write a Review

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Providence Health & Services Mt NPPES

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

PROVIDENCE HEALTH & SERVICES MT (NPI 1124268982), doing business as Providence Medical Group Montana, is a healthcare organization registered as an obesity medicine in Missoula, Montana and active in the NPI registry since March 2009. The organization lists Donald Wayne Anderson, Assistant Secretary Enrollments, as its authorized official.

NPPES Registry Identity

NPI1124268982

Entity TypeOrganization

Primary Taxonomy207RB0002X

Legal Business NamePROVIDENCE HEALTH & SERVICES MT

Location Address500 W BROADWAY ST, 4TH FLOORMissoula, MT 59802-4096

Mailing AddressPo Box 31001 - 4114Pasadena, CA 91110-4114 · (406) 329-5866

Phone(406) 329-5866

Organization SubpartYesParent: Providence Health & Services

Authorized OfficialDonald Wayne AndersonAssistant Secretary Enrollments · (425) 358-9786

Enumeration DateMarch 5, 2009

Last NPPES UpdateMay 6, 2025

NPPES CertifiedMay 6, 2025

✔ NPI 1124268982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Obesity MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RB0002X

Definition

An internal medicine physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity.

500 W BROADWAY ST, Missoula, MT 59802

Open in Google Maps ↗

Other Names 2

Doing Business AsProvidence Medical Group Montana

Other NamePmg Mt Bariatric Services

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana.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)

Providence Health & Services Mt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

325

Medicare enrollment records show 325 clinicians reassign Medicare billing to Providence Health & Services Mt, which bills Medicare for the services they deliver. Of these, 88 practice at this address and 216 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 41

Nurse Practitioner66

Family Practice22

Emergency Medicine19

Neurology19

Cardiovascular Disease (Cardiology)18

Clinical Social Worker18

Internal Medicine17

General Surgery14

33 other specialties132

Nearest to this location (20)

See all 325

Bradley Coots, MD

Plastic and Reconstructive Surgery

NPI 1972611481

500 W BROADWAY ST FL 4
Missoula, MT 59802

(406) 329-5866

✔ PECOS✔ Accepts MedicareSame address

Marco Lorio, M.D

Infectious Disease

NPI 1295140937

500 W BROADWAY ST
Missoula, MT 59802

(406) 543-7271

✔ PECOS✔ Accepts MedicareSame address

James Maddux, MD

Cardiovascular Disease (Cardiology)

NPI 1942237326

500 W BROADWAY ST SUITE 320
Missoula, MT 59802

(406) 329-5615

✔ PECOS✔ Accepts MedicareSame address

Emily Miller, NP

Nurse Practitioner

NPI 1629892609

500 W BROADWAY ST
Missoula, MT 59802

(406) 329-5615

✔ PECOS✔ Accepts MedicareSame address

Melissa Robinson, M.D.

Cardiac Electrophysiology

NPI 1831171586

500 W BROADWAY ST STE 320
Missoula, MT 59802

(406) 329-5615

✔ PECOS✔ Accepts MedicareSame address

Makenna Stavins, MD

Internal Medicine

NPI 1427708684

500 W BROADWAY ST FL 4
Missoula, MT 59802

(406) 327-1900

✔ PECOS✔ Accepts MedicareSame address

Vicente Undurraga Perl, M.D.

General Surgery

NPI 1083931067

500 W BROADWAY ST FL 4
Missoula, MT 59802

(406) 329-5828

✔ PECOS✔ Accepts MedicareSame address

Gregory Wood, M.D.

Advanced Heart Failure and Transplant Cardiology

NPI 1487821344

500 W BROADWAY ST STE 320
Missoula, MT 59802

(406) 329-5615

✔ PECOS✔ Accepts MedicareSame address

Elise Abicht, MD

Obstetrics/Gynecology

NPI 1497071054

500 W BROADWAY ST FL 4BB
Missoula, MT 59802

(406) 329-5828

✔ PECOS✔ Accepts MedicareSame address

Anthony Caffarelli, M.D.

Thoracic Surgery

NPI 1851587356

500 W BROADWAY ST STE 320
Missoula, MT 59802

(406) 329-5615

✔ PECOS✔ Accepts MedicareSame address

Kenneth Brewington, MD

Neurosurgery

NPI 1154315695

500 WEST BROADWAY STREET SUITE 310
Missoula, MT 59802

(406) 728-6520

✔ PECOS✔ Accepts MedicareSame address

Amanda Morey, M.D.

Emergency Medicine

NPI 1073703518

500 W BROADWAY ST
Missoula, MT 59802

(406) 329-5635

✔ PECOSSame address

Blair Brown, MD, MED

Preventive Medicine

NPI 1033596572

500 W BROADWAY ST FL 4
Missoula, MT 59802

(406) 327-1940

✔ PECOS✔ Accepts MedicareSame address

Sandra Cummins, LCSW

Clinical Social Worker

NPI 1386164408

500 W BROADWAY ST
Missoula, MT 59802

(406) 327-3046

✔ PECOS✔ Accepts MedicareSame address

Julia Gruetzmacher, MD

Family Practice

NPI 1962852962

500 W BROADWAY ST
Missoula, MT 59802

(406) 543-7271

✔ PECOS✔ Accepts MedicareSame address

John Lakatua, MD

Nephrology

NPI 1023063070

500 WEST BROADWAY
Missoula, MT 59802

(406) 721-5600

✔ PECOS✔ Accepts MedicareSame address

John Neathawk, D.O.

Hospitalist

NPI 1134567126

500 W BROADWAY ST ROOM 202 MAIN HOSPITAL, MSC 333
Missoula, MT 59802

(406) 543-7271

✔ PECOS✔ Accepts MedicareSame address

Michael Reed, MD

Interventional Cardiology

NPI 1346396967

500 WEST BROADWAY ST. PATRICK HOSPITAL
Missoula, MT 59802

(406) 543-7271

✔ PECOS✔ Accepts MedicareSame address

Michael Snyder, MD

Hematology

NPI 1306872999

500 W BROADWAY ST
Missoula, MT 59802

(406) 728-2539

✔ PECOS✔ Accepts MedicareSame address

Alan Thomas, MD

Medical Oncology

NPI 1548297468

500 W BROADWAY ST
Missoula, MT 59802

(406) 728-2539

✔ PECOS✔ Accepts MedicareSame address

See all 325 clinicians

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

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 Providence Health & Services Mt's NPI number?

The NPI number for Providence Health & Services Mt is 1124268982. It was assigned to this organization in the NPPES registry on March 5, 2009. The provider is doing business as Providence Medical Group Montana. The provider is also known as PMG MT Bariatric Services.

Where is Providence Health & Services Mt located?

Providence Health & Services Mt is located at 500 W Broadway St 4th Floor, Missoula, MT 59802. The listed phone number is (406) 329-5866.

What is Providence Health & Services Mt's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Obesity Medicine, with taxonomy code 207RB0002X.

Is Providence Health & Services Mt enrolled in Medicare?

Yes. Providence Health & Services Mt is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Health & Services Mt?

According to the CMS Revalidation Reassignment List (October 2026 release), 325 clinicians in 41 Medicare specialties reassign their Medicare billing to Providence Health & Services Mt. 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. The largest specialties are Nurse Practitioner (66), Family Practice (22) and Emergency Medicine (19). Of these, 88 practice at this address and 216 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Providence Health & Services Mt accept?

Health plans from Blue Cross and Blue Shield of Montana list Providence Health & Services Mt 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 Providence Health & Services Mt was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.