NPIMap

Individual provider Active NPI

Paul R Siddoway, M.D.

  • Internal Medicine Physician
  • Butte, MT
National Provider Identifier
1275564189
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6039 Issued in MT
Practice address
300 W Mercury St
Butte, MT 59701-1652
Phone
(406) 723-1300
Fax
(406) 723-1310
NPI assigned
Jul 6, 2006
Last updated
Jan 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6039 MT Primary

Addresses

Primary practice location

300 W Mercury St
Butte, MT 59701-1652

Mailing address

300 W Mercury St
Butte, MT 59701-1652
Phone (406) 723-1300

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
I20080122000177 MT Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 0547282659 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercury Street Medical Group PLLCGroup PAC ID 0345146411, 6 clinicians
Community Hospital of AnacondaGroup PAC ID 8123938974, shared by 5 NPIs, 45 clinicians

Practice addresses (Care Compare)

300 W Mercury St
Butte, MT 59701-1652
Phone (406) 723-1300

305 W Pennsylvania Ave
Anaconda, MT 59711-1900
Phone (406) 563-8571

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6039MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of Anaconda CurrentSince Aug 11, 2013 Accepting new patients
Community Hospital of Anaconda CurrentSince Aug 11, 2013 Accepting new patients
Community Hospital of Anaconda Current Accepting new patients
SCL Health Medical Group-Butte LLC CurrentSince Jan 12, 2011 Accepting new patients
Community Hospital of Anaconda Current Accepting new patients
Mercury Street Medical Group PLLC CurrentSince May 1, 2010 Accepting new patients
SCL Health Medical Group-Butte LLC CurrentSince Jan 12, 2011 Accepting new patients

Locations

305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

300 W Mercury St
Butte, MT 59701
Phone (406) 723-1300

400 S Clark St
Butte, MT 59701
Phone (406) 495-7260

401 S Alabama St
Ste 6A
Butte, MT 59701
Phone (406) 782-2329

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Stillwater HospiceButte, MT, CCN 271503 Hospice Contracted Managing Employee (25%) Oct 25, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1275564189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MERCURY ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011652",
            "telephone_number": "406-723-1300",
            "fax_number": "406-723-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MERCURY ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011652",
            "telephone_number": "406-723-1300",
            "fax_number": "406-723-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDOWAY",
        "first_name": "PAUL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "6039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butte, MT

Sources for this page

Verify at the official NPI Registry.