NPIMap

Organization Active NPI

Associated Dermatology and Skin Cancer Clinic of Helena, PC

  • Dermatology Physician
  • Helena, MT
National Provider Identifier
1497896229
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ASSOCIATED DERMATOLOGY AND SKIN CANCER CLINIC OF HELENA, PC
Practice address
50 South Last Chance
Helena, MT 59601-4130
Phone
(406) 442-3534
Fax
(406) 442-2064
NPI assigned
Feb 12, 2007
Last updated
Jun 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Dr. Jeffry Andrew Goldes, MDNPI 1871691154
Title
President
Phone
(406) 442-3534

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

50 South Last Chance
Helena, MT 59601-4130

Mailing address

50 S Last Chance Gulch
Suite 3
Helena, MT 59601-4130
Phone (406) 442-3534

Other identifiers 1

IdentifierTypeStateIssuer
CC8656OtherRAILROAD MCR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050308001112 MT Part B Supplier - Clinic/Group Practice 5193779536 Receives reassigned benefits from 6 practitioners
Practice locations: Helena, MT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D0690730Associated Dermatology & Skin Cancer Clinic50 S Last Chance Gulch, Suite 3, Helena, MT 59601ComplianceMar 14, 2027

National Provider Directory

National Provider Directory

Locations

50 S Last Chance Gulch
Helena, MT 59601
Phone (406) 442-3534

50 S Last Chance Gulch
Ste 3
Helena, MT 59601
Phone (406) 324-7453

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1497896229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S LAST CHANCE GULCH",
            "address_2": "SUITE 3",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014130",
            "telephone_number": "406-442-3534",
            "fax_number": "406-442-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 SOUTH LAST CHANCE",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014130",
            "telephone_number": "406-442-3534",
            "fax_number": "406-442-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED DERMATOLOGY AND SKIN CANCER CLINIC OF HELENA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "GOLDES",
        "authorized_official_first_name": "JEFFRY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-442-3534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "CC8656",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.