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MITCHELL GLEN HALL PAC
NPI 1164194593
Physician Assistant - Surgical in Missoula, MT

Active since October 04, 2021PECOS EnrolledAccepts Medicare Assignment
80.76/100
CMS Quality Rating
500 W BROADWAY ST FL 5, MISSOULA, MT 59802(406) 329-5866 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 9, 2025, Sep 7, 2022, Oct 4, 2021 (3 updates tracked since 2021).

About Mitchell Glen Hall Pac NPPES

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

MITCHELL GLEN HALL PAC (NPI 1164194593) is an individual surgical provider in Missoula, Montana, licensed in Montana (MED-PAC-LIC-131239) and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS, is affiliated with St. Patrick Hospital, and maintains a secondary practice location in Casper.

NPPES Registry Identity

NPI1164194593
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMITCHELL GLEN HALLCredential: PAC
Location Address500 W BROADWAY ST FL 5Missoula, MT 59802-4096
Mailing AddressPo Box 31001Pasadena, CA 91110-4110 · (406) 329-5866
Phone(406) 329-5866
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 4, 2021
Last NPPES UpdateDecember 9, 20253 updates tracked since enumeration
NPPES CertifiedDecember 9, 2025
✔ NPI 1164194593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Licenses✔ Licensed in MT · MED-PAC-LIC-131239✔ Licensed in WY · PT956
500 W BROADWAY ST FL 5, Missoula, MT 59802
Open in Google Maps ↗

Secondary Practice Location 1

Location 16600 E 2nd St Ste ACasper, WY 82609-4348 · Phone (307) 333-4363

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross Blue Shield of Wyoming, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mitchell Glen Hall Pac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214335066
PECOS Enrollment IDI20231129002370
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St. Patrick Hospital

Acute Care Hospitals · Missoula, MT
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number270014
Location500 W BroadwayMissoula, MT 59806 · Missoula County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability96
Improvement Activities40
Cost43.21

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DERON LUDWIG MD
Surgery
500 W BROADWAY ST FL 5
MISSOULA, MT 59802
Missoula County (406) 329-5866
DR. STEPHANIE SUPRENANT M.D.
Plastic Surgery
500 W BROADWAY ST FL 5
MISSOULA, MT 59802
Missoula County (406) 370-1600
RACHAEL ELIZABETH ANSTINE PA-C
Physician Assistant (Surgical)
500 W BROADWAY ST FL 5
MISSOULA, MT 59802
Missoula County (406) 329-5828
BRITTANY MAILLET ROBERTSON PA-C, MMSC
Physician Assistant
500 W BROADWAY ST FL 5
MISSOULA, MT 59802
Missoula County (406) 329-2736

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 Mitchell Hall's NPI number?

The NPI number for Mitchell Hall is 1164194593. It was assigned to this individual provider in the NPPES registry on October 4, 2021.

Where is Mitchell Hall located?

Mitchell Hall practices at 500 W Broadway St Fl 5, Missoula, MT 59802. The listed phone number is (406) 329-5866.

What is Mitchell Hall's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Mitchell Hall enrolled in Medicare?

Yes. Mitchell Hall is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mitchell Hall accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Montana and Providence Health Plan list Mitchell Hall 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.

Is Mitchell Hall affiliated with any hospitals?

According to CMS data, Mitchell Hall is affiliated with St. Patrick Hospital.

When was this NPI record last updated?

The NPPES record for Mitchell Hall was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.