MRS. PAYTON RILEY O'TOOLE
NPI 1194395376
Nurse Practitioner - Family in Billings, MT
About Mrs. Payton Riley O'toole NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. PAYTON RILEY O'TOOLE (NPI 1194395376) is an individual family provider in Billings, Montana, licensed in Montana (NUR-APRN-LIC-192850) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Billings Clinic, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Payton Riley O'toole 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.
Medicare Billing Reassignment
Medicare enrollment records show Payton O'toole reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Billings, MT 59101
- Reassigned Medicare billing, Montana enrollment
- 1,264 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 7
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Billings Clinic
Acute Care Hospitals · Billings, MTLivingston Healthcare
Critical Access Hospitals · Livingston, MTStillwater Billings Clinic
Critical Access Hospitals · Columbus, MTPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 59101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BILLINGS, MT 59101
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 Payton O'toole's NPI number?
The NPI number for Payton O'toole is 1194395376. It was assigned to this individual provider in the NPPES registry on June 29, 2021.
Where is Payton O'toole located?
Payton O'toole practices at 801 N 29th St, Billings, MT 59101. The listed phone number is (406) 238-2500.
What is Payton O'toole's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Payton O'toole enrolled in Medicare?
Yes. Payton O'toole 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.
Which organization bills Medicare for Payton O'toole's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Payton O'toole reassigns Medicare benefits to Billings Clinic (Billings, MT). The 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 Payton O'toole's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Payton O'toole accept?
Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and Providence Health Plan list Payton O'toole 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 Payton O'toole affiliated with any hospitals?
According to CMS data, Payton O'toole is affiliated with Billings Clinic, Livingston Healthcare and Stillwater Billings Clinic.
When was this NPI record last updated?
The NPPES record for Payton O'toole was last updated on December 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Mrs. Payton Riley O'toole · NPI 1194395376
Family physician in Billings, Montana. Individual provider, active in the CMS NPPES registry since June 29, 2021.
## Identity
- **NPI:** 1194395376 (Entity type: Individual)
- **Enumerated:** June 29, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** NUR-APRN-LIC-192850 (Montana)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 801 N 29TH ST, Billings, MT 59101-0905
- **Phone:** (406) 238-2500
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Billings Clinic (NPI 1376598714, Billings, MT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** December 27, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1194395376) · Data from the CMS NPPES public registry.