Individual provider Active NPI

Tracy Marie Fairbanks, MD

  • Family Medicine Physician
  • Bozeman, MT
National Provider Identifier
1134224512
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9807 Issued in MT
Practice address
935 Highland Blvd Ste 2200
Bozeman, MT 59715-6915
Phone
(406) 414-5700
Fax
(406) 586-9671
NPI assigned
Sep 13, 2006
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9807 MT Primary

Addresses

Primary practice location

935 Highland Blvd Ste 2200
Bozeman, MT 59715-6915

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfairbanks7290994@direct.sanfordhealth.org Direct Bozeman Health Deaconess Hospital

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100127000085 MT Practitioner - Family Practice 4486749876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bozeman Health Deaconess HospitalGroup PAC ID 4688984164, 309 clinicians

Practice addresses (Care Compare)

875 S Cottonwood Rd
Bozeman, MT 59718-4221

925 Highland Blvd
Suite 1220
Bozeman, MT 59715-6905
Phone (406) 414-3780

935 Highland Blvd
Suite 2200
Bozeman, MT 59715-6915
Phone (406) 414-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9807MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bozeman Health Deaconess Hospital CurrentSince Jan 1, 2016 Accepting new patients
Belgrade Clinic PLLP Family Medicine Current Accepting new patients
Family Practice Associates PC Current Accepting new patients
Bozeman Health Deaconess Hospital Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

120 N 19th Ave
Ste A
Bozeman, MT 59718
Phone (406) 556-9740

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

925 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-3780

925 Highland Blvd
Ste 1220
Bozeman, MT 59715
Phone (406) 414-3780

931 Highland Blvd
Ste 3220
Bozeman, MT 59715
Phone (406) 414-5336

935 Highland Blvd
Ste 2200
Bozeman, MT 59715
Phone (406) 219-3311

935 Highland Blvd
Ste 2210
Bozeman, MT 59715
Phone (406) 414-3133

Interoperability endpoints

  • Direct secure messaging: tfairbanks7290994@direct.sanfordhealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1134224512",
    "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": "935 HIGHLAND BLVD STE 2200",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156915",
            "telephone_number": "406-414-5700",
            "fax_number": "406-586-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "TRACY",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "9807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfairbanks7290994@direct.sanfordhealth.org",
            "affiliation": "Y",
            "affiliationName": "Bozeman Health Deaconess Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "935 Highland Blvd Ste 2200",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597156915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.