NPIMap

Individual provider Active NPI

Andrew Blackman, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Great Falls, MT
National Provider Identifier
1295998771
Registry record updated Jul 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
73861 Issued in MT
Practice address
Great Falls Clinic
3000 15TH Avenue South
Great Falls, MT 59405
Phone
(406) 454-2171
NPI assigned
Jul 6, 2008
Last updated
Jul 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2008016678 MO
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 2014015767 MO
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 107054 MN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 56811 MN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 73861 MT Primary

Addresses

Primary practice location

Great Falls Clinic
3000 15TH Avenue South
Great Falls, MT 59405

Mailing address

Great Falls Clinic
3000 15TH Avenue South
Great Falls, MT 59405
Phone (406) 454-2171

Other identifiers 1

IdentifierTypeStateIssuer
M011013436OtherMEDICARE PIN MT

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
I20190430003055 MT Practitioner - Orthopedic Surgery 5395987580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Falls Clinic LLCGroup PAC ID 8325944499, 73 clinicians

Practice addresses (Care Compare)

3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.98 of 100Reported as apm
Quality
80.39
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement32
Knee replacement64
Lower limb (leg) arthroscopy (minimally invasive joint repair)17
Upper limb (arm) arthroscopy (minimally invasive joint repair)26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008016678MOMDOrthopaedic Surgery Physician
107054MNMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Falls Clinic LLC CurrentSince Apr 15, 2019 Accepting new patients
St. Lukes Medical Group Orthopaedic Surgery Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1400 29th St S
Great Falls, MT 59405
Phone (406) 442-3570

3000 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3102

Interoperability endpoints

  • Direct secure messaging: andrew.blackman.1@25095.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25095/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1215302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562976000000",
    "number": "1295998771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GREAT FALLS CLINIC",
            "address_2": "3000 15TH AVENUE SOUTH",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "406-454-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GREAT FALLS CLINIC",
            "address_2": "3000 15TH AVENUE SOUTH",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "406-454-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-06",
        "last_updated": "2019-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2008016678",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2014015767",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "107054",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "56811",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MT",
            "license": "73861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN MT",
            "identifier": "M011013436",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.