Bentley Michael
Individual provider Active NPI Family Medicine Physician · Malmstrom Afb, MT
NPI 1235626953 · NPPES record last updated Jun 14, 2022
Key facts
- NPI
- 1235626953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2020027893 (MO)
- Practice address
- 7300 N Perimeter Rd
Malmstrom Afb, MT 59402-6701 - Phone
- (406) 731-2789
- NPI assigned
- Apr 18, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180829004498 | MO | Order and Referring Only - Family Practice |
6709136401 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020027893 | MO | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2020027893 | MO | Yes |
Addresses
Primary practice location
7300 N Perimeter Rd
Malmstrom Afb, MT 59402-6701
Mailing address
7300 N Perimeter Rd
Malmstrom Afb, MT 59402-6701
Other providers in Malmstrom Afb, MT
- Kai Yang Lei
- Robert Paul Lemme
- Matthew Christopher Little
- David Glenn Mathers
- Thomas M McCracken
- Homer Andrew Miller
- Carol F Nelson
- Richard K Newman
- Kim Noack
- Crystal Noppenberg
All providers in Malmstrom Afb, MT · Family Medicine Physician in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.