Individual provider Active NPI

Simon Crawford, PA-C

  • Physician Assistant
  • St. Ignatius, MT
National Provider Identifier
1639322191
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
551 Issued in MT
Practice address
330 Six Tract Lane
St. Ignatius, MT 59865-1029
Phone
(406) 745-2781
Fax
(406) 745-3080
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 551 MT Primary

Addresses

Primary practice location

330 Six Tract Lane
St. Ignatius, MT 59865-1029

Mailing address

330-6 Tract Lane
St. Ignatius, MT 59865-1029
Phone (406) 745-2781

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090101000006 MT Practitioner - Physician Assistant 0749342640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Community HospitalGroup PAC ID 5496659567, 59 clinicians

Practice addresses (Care Compare)

107 Ridgewater Dr
Polson, MT 59860-8977
Phone (406) 883-3737

126 6TH Ave SW
Ronan, MT 59864-2600
Phone (406) 676-3600

Hospital & facility affiliations

  • St Luke Community Hospital Hospital, Ronan, MT, CCN 271325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
551MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Community Hospital CurrentSince Dec 1, 2025 Accepting new patients
St Lukes Community Hospital CurrentSince Oct 20, 2008 Accepting new patients
St. Lukes Community Hospital CurrentSince Oct 20, 2008 Accepting new patients
St Lukes Community Hospital Past Accepting new patients

Locations

104 Rufus Ln
Polson, MT 59860
Phone (406) 543-8512

126 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

107 6th Ave SW
Ronan, MT 59864
Phone (406) 676-3600

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1639322191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330-6 TRACT LANE",
            "city": "ST. IGNATIUS",
            "state": "MT",
            "postal_code": "598651029",
            "telephone_number": "406-745-2781",
            "fax_number": "406-745-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SIX TRACT LANE",
            "city": "ST. IGNATIUS",
            "state": "MT",
            "postal_code": "598651029",
            "telephone_number": "406-745-2781",
            "fax_number": "406-745-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "SIMON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Ignatius, MT

Sources for this page

Verify at the official NPI Registry.