Orthopedic Surgical Center of Montana, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ORTHOPEDIC SURGICAL CENTER OF MONTANA, LLC

Practice address

536 S Cottonwood Rd
Ste. 100
Bozeman, MT 59718-9515

Phone

(406) 586-8029

NPI assigned

Mar 22, 2017

Last updated

Mar 22, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Deibert, M.D.NPI 1437159944

Title

President

Phone

(406) 581-9765

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Listed as

The Orthopedic Surgical Center of MontanaCCN 27C0001027

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark C Deibert, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Bozeman, MT
  • NPI 1437159944
  NPD (past) Authorized official
• Timothy O'Brien, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Bozeman, MT
  • NPI 1922008374
  NPD (past)

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1346771383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 S COTTONWOOD RD",
            "address_2": "STE. 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 S COTTONWOOD RD",
            "address_2": "STE. 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189515",
            "telephone_number": "406-586-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC SURGICAL CENTER OF MONTANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "DEIBERT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-581-9765",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Ambulatory Surgical Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.