NPIMap

Individual provider Active NPI

Puneet Victor Bansal, M.D.

  • Cardiovascular Disease Physician
  • Missoula, MT
National Provider Identifier
1417230855
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
60787 Issued in MT
Practice address
500 W Broadway St Ste 320
Missoula, MT 59802-4003
Phone
(406) 329-5615
Fax
(406) 329-5606
NPI assigned
Sep 22, 2011
Last updated
Nov 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD25659 ME
Cardiovascular Disease Physician 207RC0000X 60787 MT Primary

Addresses

Primary practice location

500 W Broadway St Ste 320
Missoula, MT 59802-4003

Mailing address

PO Box 31001
Pasadena, CA 91110-4110
Phone (406) 329-5615

Other practice location 1

121 Medical Center Dr Ste 3100
Brunswick, ME 04011-2672
Phone (207) 406-7310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180210000178 MT Practitioner - Cardiovascular Disease (Cardiology) 9830459932 Reassigns benefits to 2 organizations
I20220920003794 ME Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9830459932

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Suite 320
Missoula, MT 59802-4003
Phone (406) 329-5615

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25659MEMDCardiovascular Disease Physician
60787MTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 12, 2022 Accepting new patients
Mainehealth CurrentSince Sep 12, 2022 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt Cardiovascular Disease CurrentSince Jul 14, 2025 Accepting new patients
Providence Health & Services Mt CurrentSince Jul 14, 2025 Accepting new patients
Benefis Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

121 Medical Center Dr
Ste 3100
Brunswick, ME 04011
Phone (207) 729-7939

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

500 W Broadway St
Ste 320
Missoula, MT 59802

Interoperability endpoints

  • Direct secure messaging: pbansal3922814@wm.providencedirect.org
  • Direct secure messaging: pbansal556128@direct.mmc.mainehealth.org

Organizations & group practices 8

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 9

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": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1417230855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104110",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST STE 320",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024003",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-5606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Medical Center Dr Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040112672",
            "country_code": "US",
            "telephone_number": "207-406-7310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "PUNEET",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "MD25659",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MT",
            "license": "60787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.