NPIMap

Individual provider Active NPI

Theodore R Preiss, PA-C

  • Medical Physician Assistant
  • Bozeman, MT
National Provider Identifier
1528193265
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MT476 Issued in MT
Practice address
937 Highland Blvd Ste 5410
Bozeman, MT 59715-6916
Phone
(406) 414-3610
NPI assigned
Feb 22, 2007
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MT476 MT Primary

Addresses

Primary practice location

937 Highland Blvd Ste 5410
Bozeman, MT 59715-6916

Mailing address

915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 414-5000

Other identifiers 2

IdentifierTypeStateIssuer
1528193265MedicaidMT
000900133OtherBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tpreiss7291506@direct.sanfordhealth.org Direct

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
I20070918000629 MT Practitioner - Physician Assistant 2163516311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bozeman Health Deaconess HospitalGroup PAC ID 4688984164, 309 clinicians

Practice addresses (Care Compare)

875 S Cottonwood Rd
Bozeman, MT 59718-4221

925 Highland Blvd
Bozeman, MT 59715-6900

925 Highland Blvd
Suite 1220
Bozeman, MT 59715-6905
Phone (406) 414-3780

937 Highland Blvd
Bozeman, MT 59715-6916

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MT476MTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bozeman Health Deaconess Hospital CurrentSince Jan 1, 2016 Accepting new patients
Belgrade Clinic PLLP Current Accepting new patients
Bozeman Health Deaconess Hospital CurrentSince Jan 1, 2016 Accepting new patients
Peak Health & Wellness, LLC PastSince Oct 1, 2001 Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Peak Health and Wellness, PLLC Past Accepting new patients

Locations

3905 Wellness Way
Ste 3B
Bozeman, MT 59718
Phone (406) 414-4250

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

925 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-3780

925 Highland Blvd
Ste 1220
Bozeman, MT 59715
Phone (406) 414-3780

931 Highland Blvd
Ste 3220
Bozeman, MT 59715
Phone (406) 414-5336

937 Highland Blvd
Ste 5410
Bozeman, MT 59715
Phone (406) 414-2400

Interoperability endpoints

  • Direct secure messaging: tpreiss7291506@direct.sanfordhealth.org

Organizations & group practices 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1528193265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 HIGHLAND BLVD STE 5410",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156916",
            "telephone_number": "406-414-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREISS",
        "first_name": "THEODORE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "MT476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528193265",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000900133",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpreiss7291506@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "937 Highland Blvd Ste 5410",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597156916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.