Individual provider Active NPI

Michelle Leidenix Botner, OD

  • Optometrist
  • Whitefish, MT
National Provider Identifier
1679519805
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MT1562 Issued in MT
Practice address
509 E 6TH St
Whitefish, MT 59937-2774
Phone
(406) 862-2020
Fax
(406) 862-2385
NPI assigned
Jun 22, 2006
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ND 511 ND
Optometrist 152W00000X 1562 MT
Optometrist 152W00000X MT1562 MT Primary

Addresses

Primary practice location

509 E 6TH St
Whitefish, MT 59937-2774

Mailing address

509 E 6TH St
Whitefish, MT 59937-2774
Phone (406) 860-2020

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000617 MT Practitioner - Optometry 2567466535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitefish Eye Center LLCGroup PAC ID 1850343005, 4 clinicians

Practice addresses (Care Compare)

509 E 6TH St
Whitefish, MT 59937-2774
Phone (406) 862-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1562MTMDMental Health Counselor
MT1562MTMDOptometrist
ND 511NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Whitefish Eye Center, LLC. Optometrist CurrentSince Nov 18, 2015 Accepting new patients
Vision Clinic PLLC Optometrist PastSince Dec 1, 2006 Accepting new patients

Locations

346 Central Ave
Ste B
Whitefish, MT 59937
Phone (406) 862-2020

509 E 6th St
Whitefish, MT 59937
Phone (406) 862-2020

Organizations & group practices 2

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1679519805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 E 6TH ST",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372774",
            "telephone_number": "406-860-2020",
            "fax_number": "406-862-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 E 6TH ST",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372774",
            "telephone_number": "406-862-2020",
            "fax_number": "406-862-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTNER",
        "first_name": "MICHELLE",
        "middle_name": "LEIDENIX",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "ND 511",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "1562",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "MT1562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

Verify at the official NPI Registry.