Individual provider Active NPI

Deke Lundman, MPT

  • Physical Therapist
  • Billings, MT
National Provider Identifier
1255414124
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1511PT Issued in MT
Practice address
2702 8TH Ave N
Billings, MT 59101-1107
Phone
(406) 238-2500
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1511PT MT Primary

Addresses

Primary practice location

2702 8TH Ave N
Billings, MT 59101-1107

Mailing address

PO Box 35100
Billings, MT 59107-5100
Phone (406) 238-2500

Other identifiers 3

IdentifierTypeStateIssuer
115476100MedicaidWY
0345610MedicaidMT
0000600008OtherMTBCBS PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131122000166 MT Practitioner - Physical Therapist in Private Practice 1153557178 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1511PTMTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic CurrentSince Jun 12, 2000 Accepting new patients
Billings Clinic CurrentSince Jun 12, 2000 Accepting new patients
Billings Clinic Current Accepting new patients
Billings Clinic Past Accepting new patients

Locations

2702 8th Ave N
Billings, MT 59101
Phone (406) 238-2769

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1255414124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35100",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591075100",
            "telephone_number": "406-238-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 8TH AVE N",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591011107",
            "telephone_number": "406-238-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDMAN",
        "first_name": "DEKE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1511PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115476100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0345610",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0000600008",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.