Individual provider Active NPI

Todd J Harris, DO

  • Family Medicine Physician
  • Bozeman, MT
National Provider Identifier
1063443901
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8230 Issued in MT
Practice address
935 Highland Blvd
Suite 4400
Bozeman, MT 59715-6904
Phone
(406) 587-5123
Fax
(406) 556-6758
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8230 MT Primary

Addresses

Primary practice location

935 Highland Blvd
Suite 4400
Bozeman, MT 59715-6904

Mailing address

Family Medicine Clinic
935 Highland Blvd Ste 2200
Bozeman, MT 59715-6915
Phone (406) 414-5700

Other identifiers 2

IdentifierTypeStateIssuer
14291OtherMTBCBS
100623MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071203000153 MT Practitioner - Family Practice 5799874525

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
77.21
Promoting interoperability
100
Improvement activities
40
Cost
74.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
8230MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bozeman Health Deaconess Hospital Past Accepting new patients
Hallie Bornstein Banziger PHD LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1063443901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FAMILY MEDICINE CLINIC",
            "address_2": "935 HIGHLAND BLVD STE 2200",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156915",
            "telephone_number": "406-414-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 HIGHLAND BLVD",
            "address_2": "SUITE 4400",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156904",
            "telephone_number": "406-587-5123",
            "fax_number": "406-556-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TODD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "8230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14291",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100623",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.