Individual provider Active NPI

Philip A Bain, MD

  • Internal Medicine Physician
  • Belgrade, MT
National Provider Identifier
1386682664
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
67338 Issued in MT
Practice address
206 Alaska Frontage Rd
Belgrade, MT 59714-7909
Phone
(406) 414-3334
NPI assigned
Jun 2, 2006
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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 67338 MT Primary

Addresses

Primary practice location

206 Alaska Frontage Rd
Belgrade, MT 59714-7909

Mailing address

915 Highland Blvd
Attn PFS Credentialing
Bozeman, MT 59715-6902
Phone (406) 414-5000

Other identifiers 1

IdentifierTypeStateIssuer
1386682664MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pbain12859698@direct.sanfordhealth.org Direct Bozeman Health Deaconess Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060208000768 WI Practitioner - Internal Medicine 8325053507 Reassigns benefits to 1 organization
I20190313001779 MT Practitioner - Internal Medicine 8325053507

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67338MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Internal Medicine CurrentSince Jan 4, 2006 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jan 4, 2006 Accepting new patients

Locations

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

1821 S Stoughton Rd
Madison, WI 53716
Phone (608) 260-6000

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1386682664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "address_2": "ATTN PFS CREDENTIALING",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 ALASKA FRONTAGE RD",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597147909",
            "telephone_number": "406-414-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "PHILIP",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "67338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386682664",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbain12859698@direct.sanfordhealth.org",
            "affiliation": "Y",
            "affiliationName": "Bozeman Health Deaconess Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "206 Alaska Frontage Rd",
            "city": "Belgrade",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597147909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belgrade, MT

Sources for this page

Verify at the official NPI Registry.