Michelle Leidenix Botner, OD
Individual provider Active NPI Optometrist · Whitefish, MT
NPI 1679519805 · NPPES record last updated Apr 17, 2025
Key facts
- NPI
- 1679519805
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- MT1562 (MT)
- Practice address
- 509 E 6TH St
Whitefish, MT 59937-2774 - Phone
- (406) 862-2020
- Fax
- (406) 862-2385
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- 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 LLC
Practice addresses (Care Compare)
509 E 6TH St
Whitefish, MT 59937-2774
Phone (406) 862-2020
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 28 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130409000617 | MT | Practitioner - Optometry | 2567466535 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1562 | MT | MD | Optometrist |
| MT1562 | MT | MD | Optometrist |
| ND 511 | ND | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whitefish Eye Center, LLC. | Optometrist | Current |
Accepting new patients |
| Wellford Eye Center PLLC | Optometrist | Past | Accepting new patients |
| Vision Clinic PLLC | Optometrist | Past |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ND 511 | ND | |
| Optometrist | 152W00000X | 1562 | MT | |
| Optometrist | 152W00000X | MT1562 | MT | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679519805 | Medicaid | MT | |
| 60433 | Medicaid | ND |
Other providers in Whitefish, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.