NPIMap

Organization Active NPI

Bozeman Health Deaconess Hospital

  • General Acute Care Hospital
  • Bozeman, MT
National Provider Identifier
1104295864
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
BOZEMAN HEALTH DEACONESS HOSPITAL
Practice address
915 Highland Blvd
Bozeman, MT 59715-6902
Phone
(406) 414-5000
NPI assigned
Sep 23, 2015
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Angie Libertini
Title
Payer Enrollment Supervisor
Phone
(406) 414-1958

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

915 Highland Blvd
Bozeman, MT 59715-6902

Mailing address

915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 414-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151113002541 MT Part A Provider - Hospital 4688984164 Practice locations: Bozeman, MT; Belgrade, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104295864. Details of each certification follow.

Hospital certification: CCN 270057

Legal name
BOZEMAN HEALTH DEACONESS HOSPITAL
Doing business as
BOZEMAN HEALTH DEACONESS REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 9, 2020
Beds
140
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 16, 2016 (3 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 6, 2015 in MT
Enrollment address
915 Highland Blvd
Bozeman, MT 59715-6902
Other Hospital Practice Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Bozeman Health Deaconess HospitalCCN 270057 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

875 S Cottonwood Rd
Ste 280
Bozeman, MT 59718
Phone (406) 414-4730

931 Highland Blvd
Ste 3360
Bozeman, MT 59715
Phone (406) 414-5300

935 Highland Blvd
Ste 3260
Bozeman, MT 59715

937 Highland Blvd
Ste 5410
Bozeman, MT 59715
Phone (406) 414-2400

937 Highland Blvd
Ste 5510
Bozeman, MT 59715
Phone (406) 414-3959

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Francisco Ferreyra-Munoz Individual Corporate Director Jul 1, 2024
Corey Pulfrey Individual Corporate Officer Jul 1, 2023
John How Individual Corporate Director Jul 18, 2019
Bradley K Ludford Individual Corporate OfficerCfo Sep 5, 2018
Vickie Groeneweg Individual Corporate Director Jul 1, 2023
David J Crites Individual Corporate Director Jul 1, 2024
Meghan E Johnston Individual Corporate Officer Jul 1, 2023
Kathryn D Bertany Individual Corporate OfficerCeo/President Bozeman Health Nov 1, 2022
James Berend Individual Corporate Director Jul 1, 2022
Angie Libertini Individual W-2 Managing Employee Jul 8, 2024
Kim Scurry Individual Corporate Director Jul 1, 2024
Bozeman Deaconess Health Services Organization, Bozeman, MT Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2016 100%
Elizabeth Carver Individual Corporate Director Jul 1, 2021
Rebecca Franks Individual Corporate Director Jul 1, 2022
Jon Knokey Individual Corporate Director Jul 1, 2022
Amy Croover Individual Corporate Director Jul 1, 2024
Alyce a Schultz Individual Corporate Director Jul 1, 2020

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 335

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 335

Affiliated clinicians 539

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 539

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1104295864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOZEMAN HEALTH DEACONESS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "LIBERTINI",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "PAYER ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "406-414-1958"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.