NPIMap

Organization Active NPI

Medical Eye Specialists PC

  • Ophthalmology Physician
  • Bozeman, MT
National Provider Identifier
1093704108
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MEDICAL EYE SPECIALISTS PC
Practice address
3820 N 27TH Ave
Suite 100
Bozeman, MT 59718-5971
Phone
(406) 587-1245
NPI assigned
Oct 20, 2005
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Shane Rae Allison
Title
Practice Administrator
Phone
(406) 587-1245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

3820 N 27TH Ave
Suite 100
Bozeman, MT 59718-5971

Mailing address

3820 N 27TH Ave
Ste 100
Bozeman, MT 59718-3551
Phone (406) 587-1245

Other practice location 1

422 S Main St
Livingston, MT 59047-3456
Phone (406) 587-1245

Other practice location 2

300 N Willson Ave
Suite 1003
Bozeman, MT 59715-3578
Phone (406) 587-1245

Other practice location 3

205 W Main St
Belgrade, MT 59714-3616
Phone (406) 587-1245

Other identifiers 1

IdentifierTypeStateIssuer
CS2449OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041202000358 MT Part B Supplier - Clinic/Group Practice 5597721472 Receives reassigned benefits from 9 practitioners
Practice locations: Bozeman, MT; Livingston, MT; Belgrade, MT

National Provider Directory

National Provider Directory

Locations

205 W Main St
Belgrade, MT 59714
Phone (406) 388-2440

300 N Willson Ave
Ste 1003
Bozeman, MT 59715
Phone (406) 551-4296

3820 N 27th Ave
Ste 100
Bozeman, MT 59718
Phone (406) 587-1245

Interoperability endpoints

  • Direct secure messaging: jzangenberg@medicaleyespecialists.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1093704108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 N 27TH AVE",
            "address_2": "STE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183551",
            "telephone_number": "406-587-1245",
            "fax_number": "406-587-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 N 27TH AVE",
            "address_2": "SUITE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597185971",
            "telephone_number": "406-587-1245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "422 S Main St",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "MT",
            "postal_code": "590473456",
            "country_code": "US",
            "telephone_number": "406-587-1245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 N Willson Ave",
            "address_2": "Suite 1003",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597153578",
            "country_code": "US",
            "telephone_number": "406-587-1245",
            "fax_number": "406-587-1092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 W Main St",
            "address_purpose": "LOCATION",
            "city": "Belgrade",
            "state": "MT",
            "postal_code": "597143616",
            "country_code": "US",
            "telephone_number": "406-587-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL EYE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "406-587-1245"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS2449",
            "state": null
        }
    ],
    "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 May 20, 2024; 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.