Robert Tyler Reidenbaugh, MD

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

MEDPHYSCOMLIC114707 Issued in MT

Practice address

5 W Mendenhall St
Ste 202
Bozeman, MT 59715

Phone

(406) 219-7233

NPI assigned

Apr 16, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ty Reidenbaugh Other name

Medicare fee-for-service enrollment

Enrolled in WA, MT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

Loma Linda University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

406 Recovery Inc 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• 406 Recovery Inc

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Bozeman, MT
  • NPI 1023745247

  Addiction Medicine, MT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1487097762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4369",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837114369",
            "telephone_number": "208-810-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W MENDENHALL ST",
            "address_2": "STE 202",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-219-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDENBAUGH",
        "first_name": "ROBERT",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MT",
            "license": "MEDPHYSCOMLIC114707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TY",
            "last_name": "REIDENBAUGH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anna Redick, PT, DPT
• Robert S Redwood, M.D.
• Courtney Regan Wagner, M.D.
• Arielle Regier
• Katherine Regnier, MS, LCPC
• Karen Joyce Reif, MD
• Reilly Counseling and Consulting, PLLC
• Amber L Reilly, LCSW
• Melissa Rae Reily, M.D.
• Brandi Reinhard-Ferrese, R-DMT, LCPC

• All providers in Bozeman, MT
• Addiction Medicine (Psychiatry & Neurology) Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.