Individual provider Active NPI

Mark Ross Comaratta, M.D.

  • Ophthalmology Physician
  • Bozeman, MT
National Provider Identifier
1144286121
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
12335 Issued in MT
Practice address
1940 W Dickerson St
Suite 103
Bozeman, MT 59718-6851
Phone
(406) 284-2370
Fax
(406) 284-2372
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12335MTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marc F Comaratta MD PC Ophthalmology CurrentSince Aug 28, 2022 Accepting new patients
University Ophthalmology Services Inc. Ophthalmology Past Accepting new patients

Locations

1940 W Dickerson St
Ste 103
Bozeman, MT 59718
Phone (406) 224-2370

Interoperability endpoints

  • Direct secure messaging: mcomaratta@bozeman.intellechartdirect.net

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 12335 MT Primary

Addresses

NPPES NPI Registry

Primary practice location

1940 W Dickerson St
Suite 103
Bozeman, MT 59718-6851

Mailing address

1940 W Dickerson St
Suite 103
Bozeman, MT 59718-6851
Phone (406) 284-2370

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1144286121MedicaidMT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 4, 2013.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1144286121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 W DICKERSON ST",
            "address_2": "SUITE 103",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186851",
            "telephone_number": "406-284-2370",
            "fax_number": "406-284-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W DICKERSON ST",
            "address_2": "SUITE 103",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186851",
            "telephone_number": "406-284-2370",
            "fax_number": "406-284-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMARATTA",
        "first_name": "MARK",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MT",
            "license": "12335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144286121",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.