NPIMap

Individual provider Active NPI

Brett Montieth, MD

  • Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1457972838
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01093223A Issued in IN
Practice address
355 W 16TH St
Indianapolis, IN 46202-2207
Phone
(317) 948-5450
NPI assigned
Apr 27, 2020
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 01093223A IN Primary

Addresses

Primary practice location

355 W 16TH St
Indianapolis, IN 46202-2207

Mailing address

355 W 16TH St
Indianapolis, IN 46202-2207
Phone (605) 430-8751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20230628003699 SD Practitioner - Psychiatry 1850715301

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Sioux Falls, SD 57118-6370

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01093223AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince May 20, 2023 Accepting new patients
Avera McKennan Psychiatry CurrentSince May 20, 2023 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

Organizations & group practices 3

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.

  • Avera McKennan

    dba Avera Medical Group University Psychiatry Associates Sioux Falls

    • Psychiatry Physician
    • Sioux Falls, SD
    • NPI 1013980598
    NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    NPD

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1457972838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207",
            "telephone_number": "605-430-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207",
            "telephone_number": "317-948-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTIETH",
        "first_name": "BRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-27",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01093223A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.