PROVIDENCE HEALTH & SERVICES MT
NPI 1215222617
Family Medicine in Missoula, MT
About Providence Health & Services Mt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE HEALTH & SERVICES MT (NPI 1215222617), doing business as Providence Medical Group Montana, is a healthcare organization registered as a family medicine in Missoula, Montana and active in the NPI registry since June 2011. The organization lists Donald W Anderson, Assistant Secretary Enrollments, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 15
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation 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).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
436Medicare enrollment records show 436 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 217 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 42
Nearest to this location (20)
See all 436Missoula, MT 59802
Missoula, MT 59802
Missoula, MT 59802
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 1215222617. It was assigned to this organization in the NPPES registry on June 14, 2011. The provider is doing business as Providence Medical Group Montana.
Where is Providence Health & Services Mt located?
Providence Health & Services Mt is located at 500 W Broadway St, Missoula, MT 59802. The listed phone number is (406) 543-7271.
What is Providence Health & Services Mt's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Providence Health & Services Mt enrolled in Medicare?
Yes. Providence Health & Services Mt is registered in the Medicare PECOS enrollment system.
When is Providence Health & Services Mt's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (District of Columbia, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Providence Health & Services Mt?
According to the CMS Revalidation Reassignment List (October 2026 release), 436 clinicians in 42 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 Neurology (74), Nurse Practitioner (66) and Internal Medicine (32). Of these, 88 practice at this address and 217 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.
# Providence Health & Services Mt · NPI 1215222617
Family Medicine organization in Missoula, Montana. Organization record, active in the CMS NPPES registry since June 14, 2011.
## Identity
- **NPI:** 1215222617 (Entity type: Organization)
- **Enumerated:** June 14, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** PROVIDENCE MEDICAL GROUP MONTANA (Doing Business As)
- **Organization subpart:** Yes (part of Providence Health & Services)
- **Authorized official:** Donald Anderson, ASSISTANT SECRETARY ENROLLMENTS
## Practice location
- **Address:** 500 W BROADWAY ST, Missoula, MT 59802-4008
- **Phone:** (406) 543-7271
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, District of Columbia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 436 clinicians in 42 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Neurology (74), Nurse Practitioner (66), Internal Medicine (32); 88 practice at this address and 217 within 10 miles; [full list](https://npiprofile.com/npi/1215222617/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1215222617) · Data from the CMS NPPES public registry.