NPIMap

Individual provider Active NPI

Alyssa Panozzo, PA-C

  • Surgical Physician Assistant
  • Eureka, CA
National Provider Identifier
1528660826
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MED-PAC-LIC-98855 Issued in MT
Practice address
3225 Timber Fall CT Ste B
Eureka, CA 95503-4892
Phone
(707) 442-5700
NPI assigned
Nov 11, 2020
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1178678 NU
Surgical Physician Assistant 363AS0400X MED-PAC-LIC-98855 MT Primary

Addresses

Primary practice location

3225 Timber Fall CT Ste B
Eureka, CA 95503-4892

Mailing address

4291 Cover St
Bozeman, MT 59718-1980
Phone (315) 256-8088

Other practice location 1

925 Highland Blvd
Suite 1210/1220
Bozeman, MT 59715
Phone (406) 994-9823

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
I20220119002242 MT Practitioner - Physician Assistant 7012322522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

3901 Wellness Way
Bozeman, MT 59718-2402
Phone (406) 898-1200

3905 Wellness Way
Bozeman, MT 59718-2402
Phone (406) 898-1200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-PAC-LIC-98855MTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic Current Accepting new patients
Billings Clinic CurrentSince Oct 15, 2021 Accepting new patients
Billings Clinic CurrentSince Oct 15, 2021 Accepting new patients
Planned Parenthood: Shasta-Diablo, Inc. PastSince Nov 15, 2020 Accepting new patients

Locations

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

3905 Wellness Way
Bozeman, MT 59718
Phone (406) 587-9202

925 Highland Blvd
Ste 12101220
Bozeman, MT 59715
Phone (406) 994-9823

Interoperability endpoints

  • Direct secure messaging: alyssa.panozzopa.p1@direct.ppnorcal.nextgenshare.com
  • Direct secure messaging: apanozzo@billingsclinic.cernerdirect.com

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1528660826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4291 COVER ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597181980",
            "telephone_number": "315-256-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 TIMBER FALL CT STE B",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034892",
            "telephone_number": "707-442-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Highland Blvd",
            "address_2": "Suite 1210/1220",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "59715",
            "country_code": "US",
            "telephone_number": "406-994-9823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANOZZO",
        "first_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1178678",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "MED-PAC-LIC-98855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.