Tony Gordon Ballensky, FNP
Individual provider Active NPI Family Nurse Practitioner · Butte, MT
NPI 1124532155 · NPPES record last updated Nov 29, 2017
Key facts
- NPI
- 1124532155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 128284 (MT)
- Practice address
- 435 S Crystal St Ste 300
Butte, MT 59701-1506 - Phone
- (406) 496-3600
- NPI assigned
- Nov 29, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- SCL Health Medical Group-Butte LLC
Practice addresses (Care Compare)
3636 Harrison Ave
Butte, MT 59701-3571
Phone (406) 496-3600
400 S Clark St
Butte, MT 59701-2328
Phone (406) 495-7260
435 S Crystal St
Butte, MT 59701-1506
435 S Crystal St
Suite 240
Butte, MT 59701-1523
Phone (406) 496-3600
Hospital & facility affiliations
- Enhabit Home Health
- Compassus Home Health - Butte
- St James Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180110003535 | MT | Practitioner - Nurse Practitioner | 2567721905 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128284 | MT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SCL Health Medical Group-Butte LLC | Current |
Accepting new patients | |
| SCL Health Medical Group-Butte LLC | Current |
Accepting new patients |
Locations
400 S Clark St
Butte, MT 59701
Phone (406) 495-7260
435 S Crystal St
Ste 300
Butte, MT 59701
Phone (406) 496-3600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 128284 | MT | Yes |
Addresses
Primary practice location
435 S Crystal St Ste 300
Butte, MT 59701-1506
Mailing address
3204 Phillips St
Butte, MT 59701-4526
Phone (406) 490-0756
Other providers in Butte, MT
- Kara Assaley
- Rachel Auer
- Kathryn Lynn Bahr
- Brooke Lorae Bailey
- Balanced Care PC
- Kara Bankiewicz
- Diane I. Banks-Mohr
- Meika Larae Barney-Ruegamer
- Barrett Hospital Development Corporation
- Christine M Barry
All providers in Butte, MT · Family Nurse Practitioner in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.