Active NPI
John Bradley Pickhardt, MD
- Surgery Physician
- Missoula, MT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 6635
- Practice address
- 500 W Broadway
Missoula, MT 59802-4008 - Phone
- (406) 542-7525
- Fax
- (406) 829-0661
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 6635 | MT | Primary |
Addresses
Primary practice location
500 W Broadway
Missoula, MT 59802-4008
Mailing address
PO Box 7817
Missoula, MT 59807-7817
Phone (406) 542-7525
Other practice location 1
6 13th Ave E
Polson, MT 59860-5315
Phone (406) 883-5680
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jpickhardt140803@wm.providencedirect.org | Direct | |
| Direct Messaging Address | jpickhardt140803@wm.providencedirect.org | Direct | |
| Direct Messaging Address | jpickhardt140803@wm.providencedirect.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Arkansas College of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 W Broadway St
Missoula, MT 59802-4003
500 W Broadway St
Missoula, MT 59802-4008
500 W Broadway St
Missoula, MT 59802-4096
500 W Broadway St 3Rd FL
Missoula, MT 59802-4096
Hospital & facility affiliations
- St. Patrick Hospital
- Community Medical Center
- Providence St Joseph Medical Center
- Steele Memorial Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Mastectomy | 64 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6635 | MT | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Mt | Current | Accepting new patients | |
| Providence Health & Services Mt | Current | Accepting new patients | |
| Providence Health & Services Mt | Current | Accepting new patients | |
| Providence Health & Services Mt | Past | Accepting new patients |
Locations
500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918
500 W Broadway St
Fl 5
Missoula, MT 59802
Phone (406) 329-5866
2819 Great Northern Loop
Ste 200
Missoula, MT 59808
Phone (406) 542-7525
500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945
6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377
Interoperability endpoints
- jpickhardt140803@wm.providencedirect.org
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.
-
dba St Patrick Hospital Rehab
- Rehabilitation Hospital Unit
- Missoula, MT
- NPI 1144319138
-
dba Providence St Patrick Hospital
- General Acute Care Hospital
- Missoula, MT
- NPI 1023032588
-
dba Providence Medical Group Montana
- Family Medicine Physician
- Missoula, MT
- NPI 1215222617
-
dba PMG Mt Ihi
- Pulmonary Disease Physician
- Missoula, MT
- NPI 1427096585
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence St Patrick Hospital
- General Acute Care Hospital
- Missoula, MT
- NPI 1023032588
-
dba Montana Cancer Center at Providence St. Patrick Hospital
- Medical Oncology Physician
- Missoula, MT
- NPI 1326483587
Hospital
-
dba St Patrick Hospital Pathology
- Anatomic Pathology & Clinical Pathology Physician
- Missoula, MT
- NPI 1366185928
Hospital
-
dba St Patrick Hospital Psych
- Psychiatric Hospital Unit
- Missoula, MT
- NPI 1619058302
-
dba Prov St Joseph Med Ctr
- Critical Access Hospital
- Polson, MT
- NPI 1821184888
-
dba Community Medical Center
- General Acute Care Hospital
- Missoula, MT
- NPI 1346642899
-
- Critical Access Hospital
- Salmon, ID
- NPI 1851403265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1346283629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7817",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598077817",
"telephone_number": "406-542-7525",
"fax_number": "406-829-0661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W BROADWAY",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598024008",
"telephone_number": "406-542-7525",
"fax_number": "406-829-0661"
}
],
"practiceLocations": [
{
"address_1": "6 13th Ave E",
"address_purpose": "LOCATION",
"city": "Polson",
"state": "MT",
"postal_code": "598605315",
"country_code": "US",
"telephone_number": "406-883-5680",
"fax_number": "406-883-8910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PICKHARDT",
"first_name": "JOHN",
"middle_name": "BRADLEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MT",
"license": "6635",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jpickhardt140803@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "6 13th Ave E",
"city": "Polson",
"state": "MT",
"country_code": "US",
"postal_code": "598605315",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jpickhardt140803@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "500 W Broadway",
"city": "Missoula",
"state": "MT",
"country_code": "US",
"postal_code": "598024008",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jpickhardt140803@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "500 W Broadway",
"city": "Missoula",
"state": "MT",
"country_code": "US",
"postal_code": "598024008",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.