DR. NATHAN AARON SANDERS D.O.
NPI 1124276340
Otolaryngology in Helena, MT
NPI Status: Active since August 29, 2008
Contact Information
3116 SADDLE DR
SUITE 4
HELENA, MT
ZIP 59601
Phone: (406) 204-2409
Fax: (406) 422-5611
- Individual
- Male
- Years of Experience 18
- Otolaryngology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About NATHAN SANDERS
This page provides the complete NPI Profile along with additional information for Nathan Sanders, a provider established in Helena, Montana with a medical specialization in Otolaryngology and more than 18 years of experience. He graduated from University Of New England, College Of Osteo Medicine in 2008. The healthcare provider is registered in the NPI registry with number 1124276340 assigned on August 2008. The practitioner's primary taxonomy code is 207Y00000X with license number 21215 (MT). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1124276340
- Provider Name
- DR. NATHAN AARON SANDERS D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3116 SADDLE DR SUITE 4 HELENA, MT 59601
- Location Phone
- (406) 204-2409
- Location Fax
- (406) 422-5611
- Mailing Address
- 3116 SADDLE DRIIVE SUITE 4 HELENA, MT 59601
- Mailing Phone
- (406) 204-2409
- Mailing Fax
- (406) 422-5611
- Medical School Name
- UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
- Graduation Year
- 2008
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-29-2008
- Last Update Date
- 03-04-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Otolaryngology
- Taxonomy Code
- 207Y00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 21215
- License State
- MT
- Taxonomy Description
- An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? 902 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? 903 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Peak PPO Bronze HDHP - PPO
- Peak PPO Bronze Standard - PPO
- Peak PPO Catastrophic - PPO
- Peak PPO Gold - PPO
- Peak PPO Gold Standard - PPO
- Peak PPO Silver - PPO
- Peak PPO Silver Standard - PPO
- Plus Bronze - PPO
- Plus Bronze Standard - PPO
- Plus Gold - PPO
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1124276340 | OTHER (01) | MT | NPI |
Medicare Participation & PECOS Enrollment Status
Nathan Sanders is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Nathan Sanders is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 42487597
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20130827000182
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Diagnostic exam of nasal passages using an endoscope
Diagnostic exam of voice box using a flexible endoscope
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Removal of impacted ear wax
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
This service was performed 206 times for 125 patientsThis procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
This service was performed 46 times for 30 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 53 times for 45 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 176 times for 110 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 23 times for 22 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 66 times for 66 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 28 times for 28 patientsThis service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
This service was performed 24 times for 21 patientsImpacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
This service was performed 28 times for 24 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.63 for a new patient copayment and $17.7 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 59601 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.52
- Minimum New Patient Price $56.81
- Maximum New Patient Price $172.26
- Average New Patient Copayment $32.63
- Minimum New Patient Copayment $14.2
- Maximum New Patient Copayment $43.06
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.82
- Minimum Established Patient Price $18.24
- Maximum Established Patient Price $140.32
- Average Established Patient Copayment $17.7
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.08
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Acute Otitis Externa (AOE): Topical Therapy | 100% | 32 |
| Percentage of patients aged 2 years and older with a diagnosis of AOE who were prescribed topical preparations | ||
| Documentation of Current Medications in the Medical Record | 100% | 1308 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Patient-Specific Education | 81% | 461 |
| The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 100% | 461 |
| For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nathan Sanders is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ST PETERS HEALTH | 2475 BROADWAY HELENA, MT 59601 | (406) 442-2480 | Acute Care Hospitals | |
| BENEFIS HOSPITALS INC | 1101 26TH ST S GREAT FALLS, MT 59405 | (406) 455-5000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124276340, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 12 providers are registered at the same or a nearby location.
HELENA, MT 59601
HELENA, MT 59601
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124276340, enumerated as an "individual" on August 29, 2008.
The provider is located at 3116 SADDLE DR SUITE 4 HELENA, MT 59601 and the phone number is (406) 204-2409.
Otolaryngology with taxonomy code 207Y00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Mountain. Please consult your insurance carrier or call the provider to verify.
Nathan Sanders is affiliated with: ST PETERS HEALTH and BENEFIS HOSPITALS INC.
