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SUSAN H. AVERY MD
NPI 1437244845
Family Medicine - Adult Medicine in Great Falls, MT

Active since October 03, 2006PECOS EnrolledAccepts Medicare Assignment
401 15TH AVE S SUITE 110, GREAT FALLS, MT 59405(406) 727-0484(406) 453-9504 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Susan H. Avery Md NPPES

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

SUSAN H. AVERY MD (NPI 1437244845) is an individual adult medicine provider in Great Falls, Montana, licensed in Montana (3884) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, is affiliated with Billings Clinic, and is a graduate of Indiana University School Of Medicine (1968).

NPPES Registry Identity

NPI1437244845
Entity TypeIndividualFemale
Primary Taxonomy207QA0505X
Provider Legal NameSUSAN H. AVERYCredential: MD
Location Address401 15TH AVE S SUITE 110Great Falls, MT 59405
Mailing Address401 15th Ave S Suite 110Great Falls, MT 59405 · (406) 727-0484 · Fax (406) 453-9504
Phone(406) 727-0484
Fax(406) 453-9504
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1968
Enumeration DateOctober 3, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1437244845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in MT · 3884
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
401 15TH AVE S SUITE 110, Great Falls, MT 59405
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Other Identifiers 3

Medicare UPINE32855
Medicare ID-Type Unspecified000000523MT
Medicaid0047203MT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, Providence Health Plan.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

Susan H. Avery Md 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 ID6800938135
PECOS Enrollment IDI20100125000094
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.

Medicare Billing Reassignment

Medicare enrollment records show Susan Avery reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Susan H. Avery, MD, PC
Same address
Family Medicine
401 15TH AVE S STE 110
Great Falls, MT 59405
  • Reassigned Medicare billing, Montana enrollment
NPI 1306177092 (406) 761-2399

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 8

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This 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.
395 services163 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This 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.
196 services105 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
170 services170 patients
Removal of impacted ear wax by washing 69209
Impacted ear wax removal by washing, also known as ear irrigation, involves using a pressurized flow of water to break up and dislodge the ear wax. This safe procedure helps restore normal hearing and relieve discomfort caused by the blockage.
27 services21 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This 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.
23 services23 patients
Smoking and tobacco use intensive counseling, 4-10 minutes 99406
This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.
21 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Billings Clinic

Acute Care Hospitals · Billings, MT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270004
Location2800 10th Ave NBillings, MT 59101 · Yellowstone County
Emergency services Birthing friendly

Benefis Hospitals Inc

Acute Care Hospitals · Great Falls, MT
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270012
Location1101 26th St SGreat Falls, MT 59405 · Cascade County
Emergency services Birthing friendly

Great Falls Clinic Hospital

Acute Care Hospitals · Great Falls, MT
5/5 CMS rating
OwnershipProprietary
CMS Certification Number270086
Location3010 15th Avenue SouthGreat Falls, MT 59405 · Cascade County
Emergency services

Benefis Teton Medical Center

Critical Access Hospitals · Choteau, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271307
Location915 4th St NWChoteau, MT 59422 · Teton County
Emergency services

Northern Montana Hospital

Critical Access Hospitals · Havre, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271348
Location30 13th StHavre, MT 59501 · Hill County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.97 typical visit price
range $56.81 – $172.26
Typical copayment $21.99 (range $14.20 – $43.06)
Most-billed visit code 99203
Established Patient
$100.16 typical visit price
range $18.24 – $140.32
Typical copayment $25.04 (range $4.56 – $35.08)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
94%289 patients5/55-star benchmark: 92%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
96%543 patients5/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
87%391 patients5/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
95%66 patients4/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
100%66 patients5/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
89%66 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
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.
80%2,342 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%2,363 patients5/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
2%1,961 patients1/55-star benchmark: 96%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
97%1,883 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
86%626 patients4/55-star benchmark: 99%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
26%618 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
92%451 patients5/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
82%518 patients4/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 583 patients
58%40 patients3/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
83%626 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
19%626 patients2/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 2% · 359 patients
2%359 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
3 suppliers14 claims26 services$5.77 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers21 claims21 services$38.21 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers14 claims14 services$101.35 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers15 claims20 services$31.86 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers16 claims16 services$20.56 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers38 claims103 services$2.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Susan Avery's NPI number?

The NPI number for Susan Avery is 1437244845. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Susan Avery located?

Susan Avery practices at 401 15th Ave S Suite 110, Great Falls, MT 59405. The listed phone number is (406) 727-0484.

What is Susan Avery's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Susan Avery enrolled in Medicare?

Yes. Susan Avery 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 Susan Avery's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Avery reassigns Medicare benefits to Susan H. Avery, MD, PC (Great Falls, 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 Susan Avery's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Susan Avery accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP and Providence Health Plan list Susan Avery 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 Susan Avery affiliated with any hospitals?

According to CMS data, Susan Avery is affiliated with Billings Clinic, Benefis Hospitals Inc, Great Falls Clinic Hospital, Benefis Teton Medical Center and Northern Montana Hospital.

When was this NPI record last updated?

The NPPES record for Susan Avery was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.