Individual provider Active NPI

Justin Bouma, DO

  • Anesthesiology Physician
  • Helena, MT
National Provider Identifier
1275114282
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
152325 Issued in MT
Practice address
2475 E Broadway St
Helena, MT 59601-4928
Phone
(406) 457-4180
NPI assigned
Apr 20, 2021
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 152325 MT Primary

Addresses

Primary practice location

2475 E Broadway St
Helena, MT 59601-4928

Mailing address

PO Box 1537
Bellevue, NE 68005-1537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724001874 MT Practitioner - Anesthesiology 7517368046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Michigan State University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters HealthGroup PAC ID 7911814926, 206 clinicians

Practice addresses (Care Compare)

2475 E Broadway St
Helena, MT 59601-4928
Phone (406) 447-2828

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Health CurrentSince Aug 4, 2025 Accepting new patients
St. Peter's Health CurrentSince Aug 4, 2025 Accepting new patients
St Peter's Health Current Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

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 4

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1275114282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1537",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680051537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 E BROADWAY ST",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014928",
            "telephone_number": "406-457-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUMA",
        "first_name": "JUSTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MT",
            "license": "152325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

Verify at the official NPI Registry.