Individual provider Active NPI

Shaun Gordon Lalonde, PA-C

  • Physician Assistant
  • Hamilton, MT
National Provider Identifier
1386944528
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
633 Issued in MT
Practice address
411 W Main St
Hamilton, MT 59840-2470
Phone
(406) 363-5104
NPI assigned
Oct 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 633 MT Primary

Addresses

Primary practice location

411 W Main St
Hamilton, MT 59840-2470

Mailing address

411 W Main St
Hamilton, MT 59840-2470
Phone (406) 363-5104

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131008001167 MT Practitioner - Physician Assistant 7810121795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ravalli Family Medicine LLCGroup PAC ID 3072407196, 4 clinicians

Practice addresses (Care Compare)

411 W Main St
Hamilton, MT 59840-2470
Phone (406) 363-5104

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
633MTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Daly Memorial Hospital Corporation Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1386944528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W MAIN ST",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402470",
            "telephone_number": "406-363-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W MAIN ST",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402470",
            "telephone_number": "406-363-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALONDE",
        "first_name": "SHAUN",
        "middle_name": "GORDON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-21",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, MT

Sources for this page

Verify at the official NPI Registry.