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ETHAN HUGHES PAULEY
NPI 1528694486
Internal Medicine in Billings, MT

Active since March 22, 2020PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
801 N 29TH ST, BILLINGS, MT 59101(406) 238-5046 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 7, 2021, Mar 22, 2020 (2 updates tracked since 2020).

About Ethan Hughes Pauley NPPES

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

ETHAN HUGHES PAULEY (NPI 1528694486) is an individual internal medicine provider in Billings, Montana, licensed in Montana (88123) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Monument Health Spearfish Hospital, and is a graduate of Sanford School Of Medicine Of University Of South Dakota (2020).

NPPES Registry Identity

NPI1528694486
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameETHAN HUGHES PAULEY
Location Address801 N 29TH STBillings, MT 59101-0905
Mailing AddressPo Box 35100Billings, MT 59107-5100
Phone(406) 238-5046
Sole ProprietorNo
Medical School CMSSanford School Of Medicine Of University Of South DakotaGraduated 2020
Enumeration DateMarch 22, 2020
Last NPPES UpdateJuly 7, 20212 updates tracked since enumeration
NPPES CertifiedJune 7, 2021
✔ NPI 1528694486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MT · 88123
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
801 N 29TH ST, Billings, MT 59101
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Medica, Sanford 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

Ethan Hughes Pauley 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 ID143642413
PECOS Enrollment IDI20231004003214
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.

Areas of Expertise CMS Part B claims 4

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
410 services135 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
129 services69 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
113 services110 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
18 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Monument Health Spearfish Hospital

Acute Care Hospitals · Spearfish, SD
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430048
Location1440 N Main StSpearfish, SD 57783 · Lawrence County
Emergency services

Monument Health Rapid City Hospital

Acute Care Hospitals · Rapid City, SD
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430077
Location353 Fairmont BlvdRapid City, SD 57701 · Pennington County
Emergency services Birthing friendly

Physician 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.

New Patient
$130.52 typical visit price
range $56.81 – $172.26
Typical copayment $32.63 (range $14.20 – $43.06)
Most-billed visit code 99204
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

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.

AMANDA NEWBERN LANGVE PT
Physical Therapist
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-2500
KIRK KENFIELD PA
Physician Assistant (Surgical)
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-2500
ELIZABETH V CONNOR MD
Obstetrics & Gynecology (Gynecologic Oncology)
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-5000
ALEXANDER RAMSEY PA-C
Physician Assistant
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-2500
BILLINGS CLINIC
Occupational Therapist
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-2500
JERALD A. BELL MD
Ophthalmology
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-2501
MELANIE SCHMITZ PA-C
Physician Assistant (Surgical)
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-2500
AARON JAMES AUDET M.D.
Family Medicine
801 N 29TH ST
BILLINGS, MT 59101
Yellowstone County (406) 238-2500

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 Ethan Pauley's NPI number?

The NPI number for Ethan Pauley is 1528694486. It was assigned to this individual provider in the NPPES registry on March 22, 2020.

Where is Ethan Pauley located?

Ethan Pauley practices at 801 N 29th St, Billings, MT 59101. The listed phone number is (406) 238-5046.

What is Ethan Pauley's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ethan Pauley enrolled in Medicare?

Yes. Ethan Pauley 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 Ethan Pauley accept?

Health plans from Avera Health Plans, Medica and Sanford Health Plan list Ethan Pauley 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 Ethan Pauley affiliated with any hospitals?

According to CMS data, Ethan Pauley is affiliated with Monument Health Spearfish Hospital and Monument Health Rapid City Hospital.

When was this NPI record last updated?

The NPPES record for Ethan Pauley was last updated on July 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.