NPIMap

Individual provider Active NPI

Zackery W Witte, M.D.

  • Orthopaedic Surgery Physician
  • Missoula, MT
National Provider Identifier
1174968416
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
73318 Issued in MT
Practice address
2360 Mullan Rd Ste C
Missoula, MT 59808
Phone
(406) 721-4436
Fax
(406) 721-6053
NPI assigned
Apr 30, 2013
Last updated
Aug 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Orthopaedic Surgery Physician 207X00000X R3365 KY
Orthopaedic Surgery Physician 207X00000X 73318 MT Primary

Addresses

Primary practice location

2360 Mullan Rd Ste C
Missoula, MT 59808

Mailing address

2360 Mullan Rd Ste C
Missoula, MT 59808-1811
Phone (406) 721-4436

Other practice location 1

800 Rose St # Hq101
Lexington, KY 40536-0284
Phone (859) 218-3044

Other practice location 2

800 Rose St # Hq101
Lexington, KY 40536-0284
Phone (859) 218-3044

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
I20190828003933 MT Practitioner - Orthopedic Surgery 9234458985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missoula Bone and Joint LLCGroup PAC ID 3870583990, 57 clinicians

Practice addresses (Care Compare)

2360 Mullan Rd
Suite C
Missoula, MT 59808-1811
Phone (406) 721-4436

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.41 of 100Reported as individual
Quality
40.49
Promoting interoperability
100
Improvement activities
40
Cost
90.87

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion166
Laminectomy or laminotomy (partial removal of spine bones)73
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3365KYMDOrthopaedic Surgery Physician
73318MTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missoula Bone & Joint, LLC Orthopaedic Surgery CurrentSince Aug 19, 2019 Accepting new patients
Providence Health & Services Mt Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2360 Mullan Rd
Ste C
Missoula, MT 59808
Phone (406) 542-9695

Interoperability endpoints

  • FHIR API: https://mbnj.mmi.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 3

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 7

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": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1174968416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MULLAN RD STE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081811",
            "telephone_number": "406-721-4436",
            "fax_number": "406-721-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 MULLAN RD STE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59808",
            "telephone_number": "406-721-4436",
            "fax_number": "406-721-6053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St # Hq101",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360284",
            "country_code": "US",
            "telephone_number": "859-218-3044",
            "fax_number": "859-323-2412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Rose St # Hq101",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360284",
            "country_code": "US",
            "telephone_number": "859-218-3044",
            "fax_number": "859-323-2412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTE",
        "first_name": "ZACKERY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "R3365",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MT",
            "license": "73318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.