Individual provider Active NPI

Matthew Pett

  • Certified Registered Nurse Anesthetist
  • Havre, MT
National Provider Identifier
1487140398
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NUR-APRN-LIC-132698 Issued in MT
Practice address
Northern Montana Hospital
30 13TH St
Havre, MT 59501
Phone
(406) 262-1305
NPI assigned
Jul 3, 2018
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NUR-APRN-LIC-132698 MT Primary

Addresses

Primary practice location

Northern Montana Hospital
30 13TH St
Havre, MT 59501

Mailing address

30 13TH St
Havre, MT 59501-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190206000737 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507104197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vigilant Anesthesia Services LLCGroup PAC ID 0143756262, 7 clinicians

Practice addresses (Care Compare)

2440 Winne Ave
Suite 100
Helena, MT 59601-4913
Phone (406) 457-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-132698MTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Anesthesia Associates Mt LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 23, 2021 Accepting new patients
Northern Montana Hospital Registered Nurse Current Accepting new patients
Northern Montana Hospital CurrentSince Nov 7, 2018 Accepting new patients
Northern Montana Hospital Registered Nurse CurrentSince Nov 7, 2018 Accepting new patients
Vigilant Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2024 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

30 13th St
Havre, MT 59501
Phone (406) 262-1302

2440 Winne Ave
Ste 100
Helena, MT 59601
Phone (406) 452-4200

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1487140398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 13TH ST",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "595015222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHERN MONTANA HOSPITAL",
            "address_2": "30 13TH ST",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "59501",
            "telephone_number": "406-262-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETT",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "NUR-APRN-LIC-132698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.