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Individual provider Active NPI

Mark C Deibert, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Bozeman, MT
National Provider Identifier
1437159944
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
8221 Issued in MT
Practice address
536 Cottonwood Rd
Suite 100
Bozeman, MT 59718
Phone
(406) 586-8029
Fax
(406) 586-8009
NPI assigned
Jul 26, 2005
Last updated
Oct 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 8221 MT Primary

Addresses

Primary practice location

536 Cottonwood Rd
Suite 100
Bozeman, MT 59718

Mailing address

536 Cottonwood Rd
Suite 100
Bozeman, MT 59718
Phone (406) 586-8029

Other identifiers 3

IdentifierTypeStateIssuer
01458-1OtherMTBCBSMT
0000104686MedicaidMT
1194070001OtherMTCIGNA DME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000447 MT Practitioner - Orthopedic Surgery 2466428834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Orthopedics and Sports MedicineGroup PAC ID 7113993577, 9 clinicians

Practice addresses (Care Compare)

536 S Cottonwood Rd
100 Alpine Orthopedics and Sports Medicine
Bozeman, MT 59718-9529
Phone (406) 586-8029

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement13
Lower limb (leg) arthroscopy (minimally invasive joint repair)23
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8221MTMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Orthopedics Current Accepting new patients
Alpine Orthopedics & Sports Medicine Sports Medicine CurrentSince Sep 22, 1997 Accepting new patients
Orthopedic Surgical Center of Montana, LLC PastSince Mar 1, 2020 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

536 S Cottonwood Rd
Ste 10
Bozeman, MT 59718
Phone (406) 586-8029

536 S Cottonwood Rd
Ste 100
Bozeman, MT 59718
Phone (406) 586-8029

935 Highland Blvd
Ste 2180
Bozeman, MT 59715
Phone (406) 414-5331

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1437159944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 COTTONWOOD RD",
            "address_2": "SUITE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-586-8029",
            "fax_number": "406-586-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 COTTONWOOD RD",
            "address_2": "SUITE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-586-8029",
            "fax_number": "406-586-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIBERT",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MT",
            "license": "8221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMT",
            "identifier": "01458-1",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000104686",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DME",
            "identifier": "1194070001",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.