Byron David Baldridge, MD
Individual provider Active NPI Dermatology Physician · Helena, MT
NPI 1720073596 · NPPES record last updated Feb 20, 2023
Key facts
- NPI
- 1720073596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 4902 (MT)
- Practice address
- 1 Medical Park Dr # 201B
Helena, MT 59601-8022 - Phone
- (406) 443-7200
- Fax
- (406) 443-7201
- NPI assigned
- Sep 16, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.16 of 100
- Quality
- 92.95
- Improvement activities
- 40
- Cost
- 79.95
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: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100105000230 | MT | Practitioner - Dermatology | 7810038429 |
Receives reassigned benefits from 1 practitioner Practice locations: Great Falls, MT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4902 | MT | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Byron David Baldridge | Dermatology | Current |
Accepting new patients |
| Epiphany Dermatology of Montana, PLLC | Dermatology | Current |
Accepting new patients |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
24 E Broadway St
Butte, MT 59701
Phone (406) 310-1376
2300 12th Ave S
Ste 101
Great Falls, MT 59405
Phone (406) 727-1131
400 13th Ave S
Ste 206
Great Falls, MT 59405
Phone (406) 731-8852
400 13th Ave S
Great Falls, MT 59405
1 Medical Park Dr
Ste 201B
Helena, MT 59601
Phone (406) 443-7200
7300 Ranch Road 2222
Bldg 1
Austin, TX 78730
Interoperability endpoints
- byron.baldridge@epiphanyderm.emadirect.md
- david.baldridge.1@6613.direct.athenahealth.com
- https://api.platform.athenahealth.com/6613/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | 4902 | MT | |
| MOHS-Micrographic Surgery Physician | 207ND0101X | 4902 | MT | |
| Dermatology Physician | 207N00000X | 4902 | MT | Yes |
Addresses
Primary practice location
1 Medical Park Dr # 201B
Helena, MT 59601-8022
Mailing address
7300 Ranch Road 2222
Building 1, Ste 200
Austin, TX 78730
Phone (512) 628-0465
Other practice location 1
2300 12th Ave S
Suite 101
Great Falls, MT 59405-5017
Phone (406) 727-1131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070000634 | Other | MT | RAILROAD MEDICARE |
| 0071422 | Medicaid | MT |
Other providers in Helena, MT
- Back in Action Chiropractic, PLLC
- Backcountry Health
- Jessica Ann Elliott Bailey
- Stacy Baird
- Balanced Chiropractic, PC
- Britt Rae Ballinger
- Timothy C Ballweber
- Charla Banks
- Sarah Bankston
- August Barany
All providers in Helena, MT · Dermatology Physician in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2023. 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.