Individual provider Active NPI

Blythe Lindsay, PAC

  • Medical Physician Assistant
  • Bozeman, MT
National Provider Identifier
1649365271
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
419 Issued in MT
Practice address
1648 Ellis Street
Suite 301
Bozeman, MT 59715-8811
Phone
(406) 556-9798
Fax
(406) 556-9798
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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 419 MT Primary

Addresses

Primary practice location

1648 Ellis Street
Suite 301
Bozeman, MT 59715-8811

Mailing address

1648 Ellis Street
Suite 301
Bozeman, MT 59715-8811
Phone (406) 556-9798

Other practice location 1

2055 N 22nd Ave Ste 1
Bozeman, MT 59718-2796
Phone (406) 556-9798

Other identifiers 2

IdentifierTypeStateIssuer
419OtherMTSTATE LICENSE
0183833MedicaidMT

Other names 1

  • Blythe Lindsay Nirgenau Other name

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
I20050729000682 MT Practitioner - Physician Assistant 5991733057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridger Ear, Nose and Throat PLLCGroup PAC ID 7315950037, 2 clinicians

Practice addresses (Care Compare)

1648 Ellis St
Suite 301
Bozeman, MT 59715-8811
Phone (406) 556-9798

1648 Ellis Street
Suite 301
Bozeman, MT 59715-8811

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
419MTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Bates Family Diversified, LLC Past Accepting new patients
Three Rivers Clinic LLC Past Accepting new patients
Manhattan Medical Services Medical Past Accepting new patients

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 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1649365271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 ELLIS STREET",
            "address_2": "SUITE 301",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158811",
            "telephone_number": "406-556-9798",
            "fax_number": "406-556-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 ELLIS STREET",
            "address_2": "SUITE 301",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158811",
            "telephone_number": "406-556-9798",
            "fax_number": "406-556-9798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 N 22nd Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597182796",
            "country_code": "US",
            "telephone_number": "406-556-9798",
            "fax_number": "406-556-9795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "BLYTHE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "419",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0183833",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLYTHE",
            "last_name": "NIRGENAU",
            "middle_name": "LINDSAY",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.