SCOTT M GUESS M.D.
NPI 1861543712
Ophthalmology in Missoula, MT

Active since January 16, 2007PECOS EnrolledAccepts Medicare Assignment
92.6/100
CMS Quality Rating
700 W KENT AVE, MISSOULA, MT 59801(406) 541-3937(406) 541-3811 Get Directions Write a Review

NPPES record last updated: August 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Scott M Guess M.d. NPPES

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

SCOTT M GUESS M.D. (NPI 1861543712) is an individual ophthalmology provider in Missoula, Montana, licensed in Montana (12260) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1861543712
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameSCOTT M GUESSCredential: M.D.
Location Address700 W KENT AVEMissoula, MT 59801-6772
Mailing Address700 W. KentMissoula, MT 59801-6700 · (406) 541-3918 · Fax (406) 541-3918
Fax(406) 541-3811
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJanuary 16, 2007
Last NPPES UpdateAugust 12, 2024
NPPES CertifiedAugust 12, 2024
NPI 1861543712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License Licensed in MT · 12260
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X · License 12260 (MT)
700 W KENT AVE, Missoula, MT 59801

Secondary Practice Locations 3

Location 1120 S 5th St Ste 104Hamilton, MT 59840-2798 · Phone (406) 363-3366 · Fax (406) 541-3811
Location 23116 Saddle Dr Ste 3Helena, MT 59601-8645 · Phone (406) 443-4040 · Fax (406) 541-3811
Location 32760 Elizabeth Warren Ave Ste BButte, MT 59701-3979 · Phone (406) 792-1250 · Fax (406) 541-3811

Accepted 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

Scott M Guess M.d. 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 ID5597881433
PECOS Enrollment IDI20100928001062
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 26

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
36,600 services132 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
2,243 services451 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,986 services990 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
1,893 services180 patients
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.
1,507 services738 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.
300 services300 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59801 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
$70.82 typical visit price
range $18.24 – $140.32
Typical copayment $17.70 (range $4.56 – $35.08)
Most-billed visit code 99213
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.

92.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability94
Improvement Activities40
Cost80.35

Reported Quality Measures

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
100%108 patients5/55-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 3

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

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
2 suppliers19 claims19 services$54.19 avg. paid by Medicare
Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier13 claims25 services$58.84 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
2 suppliers11 claims21 services$51.75 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Technician/Technologist (Optician)
700 W KENT AVE
MISSOULA, MT 59801
Otolaryngology
700 W KENT AVE
MISSOULA, MT 59801
Nurse Anesthetist, Certified Registered
700 W KENT AVE
MISSOULA, MT 59801
Ophthalmology
700 W KENT AVE
MISSOULA, MT 59801
Optometrist
700 W KENT AVE
MISSOULA, MT 59801
Ophthalmology
700 W KENT AVE
MISSOULA, MT 59801
Audiologist
700 W KENT AVE
MISSOULA, MT 59801
Ophthalmology
700 W KENT AVE
MISSOULA, MT 59801

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 Scott Guess's NPI number?

The NPI number for Scott Guess is 1861543712. It was assigned to this individual provider in the NPPES registry on January 16, 2007.

Where is Scott Guess located?

Scott Guess practices at 700 W Kent Ave, Missoula, MT 59801. The listed phone number is (406) 541-3937.

What is Scott Guess's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Scott Guess enrolled in Medicare?

Yes. Scott Guess 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 Scott Guess accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Mountain Health CO-OP and PacificSource Health Plans and 1 other insurer list Scott Guess 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 Scott Guess was last updated on August 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.