Individual provider Active NPI

Michael A Jasumback, MD

  • Emergency Medicine Physician
  • Great Falls, MT
National Provider Identifier
1114947843
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A64035 Issued in CA
Practice address
1101 26TH St S
Great Falls, MT 59405-5161
Phone
(406) 455-5200
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A64035 CA Primary

Addresses

Primary practice location

1101 26TH St S
Great Falls, MT 59405-5161

Mailing address

1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 455-5200

Other identifiers 3

IdentifierTypeStateIssuer
1114947843MedicaidMT
00A640350MedicaidCA
00A640350OtherCABLUE SHIELD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address benefishealthsystem@direct.summit-healthcare.org Benefis Hospitals Inc
Direct Messaging Address mjasumback19644@benefishs.direct-ci.com Benefis Hospitals Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070313000646 CA Practitioner - Emergency Medicine 6204838147 Reassigns benefits to 1 organization
I20150522000324 MT Practitioner - Emergency Medicine 6204838147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 455-5000

Hospital & facility affiliations

  • Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100Reported as group
Quality
62.64
Promoting interoperability
100
Improvement activities
40
Cost
80.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A64035CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Benefis Hospitals Inc CurrentSince Jun 15, 2015 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2175 Rosaline Ave
Redding, CA 96001
Phone (530) 225-7247

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

Organizations & group practices 4

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 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1114947843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-455-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-455-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASUMBACK",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-04-08",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A64035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114947843",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A640350",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A640350",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benefishealthsystem@direct.summit-healthcare.org",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "1101 26th St S",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594055161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjasumback19644@benefishs.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "1101 26th St S",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594055161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.