Mitchell Glen Hall, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MED-PAC-LIC-131239 Issued in MT

Practice address

500 W Broadway St FL 5
Missoula, MT 59802-4096

Phone

(406) 329-5866

NPI assigned

Oct 4, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY, MT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhall4111542@wm.providencedirect.org
• Direct secure messaging: mhall9@billingsclinic.cernerdirect.com

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.

• Providence Health & Services Mt

  dba St Patrick Hospital Rehab

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment Care Compare group NPD
• Billings Clinic

  • Emergency Care Clinic/Center
  • Billings, MT
  • NPI 1326104845
  Medicare reassignment
• Precision Surgical PC

  • Surgery Physician
  • Casper, WY
  • NPI 1467183327
  Medicare reassignment
• Billings Clinic

  dba Aspen Meadows Nursing Home

  • Skilled Nursing Facility
  • Billings, MT
  • NPI 1033275557
  NPD
• Billings Clinic

  • General Practice Physician
  • Billings, MT
  • NPI 1376598714
  NPD
• Providence Health & Services Mt

  dba Providence Medical Group Montana

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215222617
  NPD
• Providence Health & Services Mt

  dba 1871825018

  • Nephrology Physician
  • Missoula, MT
  • NPI 1871825018
  NPD
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1154687812
  NPD
• Providence Health & Services Mt

  dba PMG Mt Ihi

  • Pulmonary Disease Physician
  • Missoula, MT
  • NPI 1427096585
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Mt

  dba Providence St Patrick Hospital

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  dba Montana Cancer Center at Providence St. Patrick Hospital

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  dba St Patrick Hospital Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  dba St Patrick Hospital Psych

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1164194593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104110",
            "telephone_number": "406-329-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST FL 5",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024096",
            "telephone_number": "406-329-5866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 E 2nd St Ste A",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826094348",
            "country_code": "US",
            "telephone_number": "307-333-4363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "MITCHELL",
        "middle_name": "GLEN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-04",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "MED-PAC-LIC-131239",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WY",
            "license": "PT956",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Haidle
• Allison Lee Hale, OT
• Danyel Marie Halko, ATC
• Jason Hall, APRN
• Jennifer K Hall, MD
• Robert Stuart Hall, PH.D.
• Thomas Drew Hall, O.D.
• Helen F Hallenbeck, AUD
• Jeffrey Haller, MD
• Naomi Haller, CCC-SLP

• Surgical Physician Assistant in Missoula, MT
• Providers in Missoula, MT by specialty
• Surgical Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.