Stephanie Suprenant, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

70012 Issued in MT

Practice address

500 W Broadway St FL 5
Missoula, MT 59802-4008

Phone

(406) 370-1600

Fax

(406) 329-5864

NPI assigned

Apr 10, 2012

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie Renee Suprenant Former name

Medicare fee-for-service enrollment

Enrolled in MT

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 1

Specialty

Plastic and Reconstructive SurgeryAlso: Hand Surgery, Maxillofacial Surgery

Education

Southern Illinois University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellspring Health and Aesthetics PLLCGroup PAC ID 6709240096, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Medical Center Hospital, Missoula, MT, CCN 270023
• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssuprenant@direct.communitymed.org
• Direct secure messaging: wellspringhealthandaestheticspllc.stephaniesuprenant@156607.advancedmd-direct.com

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.

• Wellspring Health and Aesthetics PLLC

  • Plastic Surgery Physician
  • Missoula, MT
  • NPI 1487339750
  Medicare reassignment Care Compare group NPD Authorized official
• RCHP Billings - Missoula LLC

  dba Community Physician Group

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1376946913
  Medicare reassignment NPD
• RCHP Billings - Missoula LLC

  dba Community Medical Center

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  NPD
• RCHP Billings - Missoula LLC

  dba Community Physician Group

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1891164125
  NPD

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

• Providence Health & Services Mt

  dba Providence St Patrick Hospital

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  dba Montana Cancer Center at Providence St. Patrick Hospital

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  dba St Patrick Hospital Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  dba St Patrick Hospital Psych

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  dba Community Medical Center

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1508122938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST FL 5",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-370-1600",
            "fax_number": "406-329-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST FL 5",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-370-1600",
            "fax_number": "406-329-5864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Uw Hospital and Clinics 600 Highland Ave",
            "address_2": "H4/831",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-1367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPRENANT",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "62485",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MT",
            "license": "70012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SUPRENANT",
            "middle_name": "RENEE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Plastic Surgery Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Plastic Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.