Organization Active NPI

Rocky Mountain Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Bozeman, MT
National Provider Identifier
1275515157
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
10413 Issued in MT
Legal business name
ROCKY MOUNTAIN SURGICAL CENTER, LLC
Practice address
1450 Ellis St
Suite 101
Bozeman, MT 59715-8812
Phone
(406) 556-9000
Fax
(406) 556-9119
NPI assigned
Nov 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jayne L Rasmussen
Title
Executive Director
Phone
(406) 522-1141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 10413 MT Primary

Addresses

Primary practice location

1450 Ellis St
Suite 101
Bozeman, MT 59715-8812

Mailing address

1450 Ellis St
Suite 101
Bozeman, MT 59715-8812
Phone (406) 556-9000

Other identifiers 1

IdentifierTypeStateIssuer
0351339MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000762 MT Part B Supplier - Ambulatory Surgical Center 1052225257 Practice locations: Bozeman, MT

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Rocky Mountain Surgical CenterCCN 27C0001021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D1009971Rocky Mountain Surgical Center1450 Ellis Street Suite 101, Bozeman, MT 59715Certificate of waiverMar 2, 2027

National Provider Directory

National Provider Directory

Locations

1450 Ellis St
Ste 101
Bozeman, MT 59715
Phone (406) 414-5336

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275515157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 ELLIS ST",
            "address_2": "SUITE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158812",
            "telephone_number": "406-556-9000",
            "fax_number": "406-556-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 ELLIS ST",
            "address_2": "SUITE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158812",
            "telephone_number": "406-556-9000",
            "fax_number": "406-556-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RASMUSSEN",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "406-522-1141"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MT",
            "license": "10413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0351339",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.