NPIMap

Individual provider Active NPI

Jason Richard Hurd, M.D.

  • Vascular Surgery Physician
  • Missoula, MT
National Provider Identifier
1093081150
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
77208 Issued in MT
Practice address
500 W Broadway St
Missoula, MT 59802
Phone
(406) 329-5615
Fax
(406) 329-2791
NPI assigned
Mar 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 77208 MT
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X 77208 MT Primary

Addresses

Primary practice location

500 W Broadway St
Missoula, MT 59802

Mailing address

500 W Broadway St
Missoula, MT 59802-4096
Phone (406) 329-5615

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhurd1112173@wm.providencedirect.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190702003135 MT Practitioner - Vascular SurgeryPractitioner - General Surgery 9931433455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 329-5828

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion12
Leg revascularization (restoring blood flow)26
Removal of tissue13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77208MTMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt CurrentSince Jul 13, 2019 Accepting new patients
Providence Health & Services Mt CurrentSince Jul 13, 2019 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt Past Accepting new patients
Providence Health & Services Mt Past Accepting new patients

Locations

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

Interoperability endpoints

  • Direct secure messaging: jhurd1112173@wm.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1093081150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024096",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59802",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURD",
        "first_name": "JASON",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-22",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "77208",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MT",
            "license": "77208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhurd1112173@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 W Broadway St",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "59802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.