NPIMap

Individual provider Active NPI

Jeffrey Devin Redshaw, M.D.

  • Urology Physician
  • Missoula, MT
National Provider Identifier
1134548597
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
72509 Issued in MT
Practice address
2875 Tina Ave Ste 101
Missoula, MT 59808-1582
Phone
(406) 728-3366
Fax
(406) 728-0651
NPI assigned
Apr 15, 2014
Last updated
Aug 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 72509 MT Primary

Addresses

Primary practice location

2875 Tina Ave Ste 101
Missoula, MT 59808-1582

Mailing address

2875 Tina Ave
Missoula, MT 59808-1581
Phone (406) 728-3366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190828002000 MT Practitioner - Urology 3971811902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Washington School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Five Valleys UrologyGroup PAC ID 3870497571, 7 clinicians

Practice addresses (Care Compare)

2875 Tina Rd
Suite 101
Missoula, MT 59808
Phone 40672833665651

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72509MTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Five Valleys Urology Single Specialty CurrentSince Sep 1, 2019 Accepting new patients

Locations

2875 Tina Ave
Ste 101
Missoula, MT 59808
Phone (406) 728-3366

Interoperability endpoints

  • Direct secure messaging: jredshaw@fvu.emadirect.md

Organizations & group practices 1

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 8

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1134548597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 TINA AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081581",
            "telephone_number": "406-728-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 TINA AVE STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081582",
            "telephone_number": "406-728-3366",
            "fax_number": "406-728-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDSHAW",
        "first_name": "JEFFREY",
        "middle_name": "DEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MT",
            "license": "72509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.