NPIMap

Individual provider Active NPI

Benjamin D Grass, M.D.

  • Family Medicine Physician
  • Ronan, MT
National Provider Identifier
1467894121
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50100 Issued in MT
Practice address
107 6TH Ave SW
Ronan, MT 59864-2634
Phone
(406) 676-4441
Fax
(406) 676-0835
NPI assigned
Jul 23, 2013
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50100 MT Primary

Addresses

Primary practice location

107 6TH Ave SW
Ronan, MT 59864-2634

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (866) 747-2455

Other practice location 1

6 13th Ave E
Polson, MT 59860-5315
Phone (406) 883-5680

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
I20150224000869 MT Practitioner - Family Practice 1759607492 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 329-5828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50100MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Current Accepting new patients
St Lukes Community Hospital CurrentSince Nov 1, 2016 Accepting new patients
Credena Health LLC CurrentSince Jun 1, 2023 Accepting new patients
Providence Health & Services Mt Family Medicine CurrentSince Dec 10, 2017 Accepting new patients
St. Lukes Community Hospital Family Medicine Current Accepting new patients
Partnership Health Center Inc Family Medicine Current Accepting new patients
Partnership Health Center Inc CurrentSince Dec 12, 2016 Accepting new patients
Providence Health & Services Mt CurrentSince Dec 10, 2017 Accepting new patients
St Lukes Community Hospital CurrentSince Nov 1, 2016 Accepting new patients
Providence St Joseph Medical Center Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Providence Health & Services Mt Past Accepting new patients

Locations

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

107 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

126 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

Organizations & group practices 11

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1467894121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "866-747-2455",
            "fax_number": "406-676-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 6TH AVE SW",
            "city": "RONAN",
            "state": "MT",
            "postal_code": "598642634",
            "telephone_number": "406-676-4441",
            "fax_number": "406-676-0835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 13th Ave E",
            "address_purpose": "LOCATION",
            "city": "Polson",
            "state": "MT",
            "postal_code": "598605315",
            "country_code": "US",
            "telephone_number": "406-883-5680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRASS",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "50100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronan, MT

Sources for this page

Verify at the official NPI Registry.