Individual provider Active NPI

James A. Jutzy, M.D.

  • Diagnostic Radiology Physician
  • Bozeman, MT
National Provider Identifier
1578525044
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5283 Issued in MT
Practice address
1648 Ellis St Ste 201
Bozeman, MT 59715-8811
Phone
(406) 587-8631
Fax
(406) 587-1343
NPI assigned
Apr 3, 2006
Last updated
Sep 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5283 MT Primary

Addresses

Primary practice location

1648 Ellis St Ste 201
Bozeman, MT 59715-8811

Mailing address

1648 Ellis St Ste 201
Bozeman, MT 59715-8811
Phone (406) 587-8631

Other identifiers 2

IdentifierTypeStateIssuer
0144716MedicaidMT
0061958MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5283MTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gallatin Valley Anesthesia Associates PC PastSince Mar 1, 2007 Accepting new patients

Organizations & group practices 1

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1578525044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 ELLIS ST STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158811",
            "telephone_number": "406-587-8631",
            "fax_number": "406-587-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 ELLIS ST STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158811",
            "telephone_number": "406-587-8631",
            "fax_number": "406-587-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUTZY",
        "first_name": "JAMES",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MT",
            "license": "5283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0144716",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061958",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.