Individual provider Active NPI

Rosalee Shorter, P.A.

  • Surgical Physician Assistant
  • Saint Regis, MT
National Provider Identifier
1457576407
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
36405 Issued in MT
Practice address
341 Montana Hwy 135
Saint Regis, MT 59866-0176
Phone
(406) 649-7307
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 36405 MT Primary

Addresses

Primary practice location

341 Montana Hwy 135
Saint Regis, MT 59866-0176

Mailing address

PO Box 176
Saint Regis, MT 59866-0176
Phone (406) 649-7307

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
I20151028000091 MT Practitioner - Physician Assistant 9830156637 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36405MTMDSurgical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1457576407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 176",
            "city": "SAINT REGIS",
            "state": "MT",
            "postal_code": "598660176",
            "telephone_number": "406-649-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MONTANA HWY 135",
            "city": "SAINT REGIS",
            "state": "MT",
            "postal_code": "598660176",
            "telephone_number": "406-649-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTER",
        "first_name": "ROSALEE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "36405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Regis, MT

Sources for this page

Verify at the official NPI Registry.