NPIMap

Organization Active NPI

Alpine Orthopedics & Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Bozeman, MT
National Provider Identifier
1083626832
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
ALPINE ORTHOPEDICS & SPORTS MEDICINE
Practice address
536 Cottonwood Rd
Suite 100
Bozeman, MT 59718
Phone
(406) 586-8029
Fax
(406) 586-8009
NPI assigned
Aug 12, 2006
Last updated
Oct 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Mark C Deibert, MDNPI 1437159944
Title
President
Phone
(406) 586-8029

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X 8221 MT
Orthopaedic Trauma PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0801X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

536 Cottonwood Rd
Suite 100
Bozeman, MT 59718

Mailing address

536 Cottonwood Rd
Suite 100
Bozeman, MT 59718
Phone (406) 586-8029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040907001208 MT Part B Supplier - Clinic/Group Practice 7113993577 Receives reassigned benefits from 15 practitioners
Practice locations: Bozeman, MT
O20100930053439 MT DME Supplier - Physician - Orthopedic/Orthopedic Surgery 7113993577 Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

536 S Cottonwood Rd
Ste 10
Bozeman, MT 59718
Phone (406) 586-8029

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1083626832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 COTTONWOOD RD",
            "address_2": "SUITE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-586-8029",
            "fax_number": "406-586-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 COTTONWOOD RD",
            "address_2": "SUITE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-586-8029",
            "fax_number": "406-586-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE ORTHOPEDICS & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "DEIBERT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-586-8029",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MT",
            "license": "8221",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.