Individual provider Active NPI

Brandt Dennehy, O.D.

  • Optometrist
  • Butte, MT
National Provider Identifier
1093880692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
670 Issued in MT
Practice address
2410 Amherst Ave
Butte, MT 59701-3800
Phone
(406) 494-6692
Fax
(406) 494-2205
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 670 MT Primary

Addresses

Primary practice location

2410 Amherst Ave
Butte, MT 59701-3800

Mailing address

2260 South Dr
Butte, MT 59701-6168
Phone (406) 782-6212

Other identifiers 1

IdentifierTypeStateIssuer
480709MedicaidMT

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100107000395 MT Practitioner - Optometry 5294876694 Practice locations: Butte, MT

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2410 Amherst Ave
Butte, MT 59701-3800
Phone (406) 494-6692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
670MTMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093880692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 SOUTH DR",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597016168",
            "telephone_number": "406-782-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 AMHERST AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597013800",
            "telephone_number": "406-494-6692",
            "fax_number": "406-494-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNEHY",
        "first_name": "BRANDT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480709",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butte, MT

Sources for this page

Verify at the official NPI Registry.