Individual provider Active NPI

Ruthann Rafacz, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendive, MT
National Provider Identifier
1063739704
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
178334 Issued in MT
Practice address
107 Dilworth St
Glendive, MT 59330-2053
Phone
(406) 345-8901
NPI assigned
Apr 20, 2010
Last updated
May 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 178334 MT Primary

Addresses

Primary practice location

107 Dilworth St
Glendive, MT 59330-2053

Mailing address

468 Mountain View Rd
Blanchard, ID 83804-8544
Phone (208) 437-0780

Other practice location 1

1090 W Park Pl
Coeur D Alene, ID 83814-2785
Phone (208) 292-0301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100805000167 ID Practitioner - Nurse Practitioner 8123151560 Reassigns benefits to 1 organization
I20211122002672 MT Practitioner - Nurse Practitioner 8123151560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
178334MTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic Current Accepting new patients
Billings Clinic CurrentSince Dec 12, 2024 Accepting new patients
Billings Clinic CurrentSince Dec 12, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Steele Memorial Medical Center CurrentSince Sep 23, 2017 Accepting new patients
Steele Memorial Medical Center CurrentSince Sep 23, 2017 Accepting new patients

Locations

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

1020 N 27th St
Billings, MT 59101
Phone (406) 238-2000

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

Interoperability endpoints

  • Direct secure messaging: rrafacz816401@wm.providencedirect.org
  • Direct secure messaging: ruthann.rafacz.1@24287.direct.athenahealth.com

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1063739704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 MOUNTAIN VIEW RD",
            "city": "BLANCHARD",
            "state": "ID",
            "postal_code": "838048544",
            "telephone_number": "208-437-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1090 W Park Pl",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142785",
            "country_code": "US",
            "telephone_number": "208-292-0301",
            "fax_number": "208-664-5346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAFACZ",
        "first_name": "RUTHANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "178334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendive, MT

Sources for this page

Verify at the official NPI Registry.