Aerosurgical Montana LLC – Clinic/Center

Key facts

NPI: 1720632201
Entity type: Organization (NPI type 2)
Primary specialty: Clinic/Center 261Q00000X
Legal business name: AEROSURGICAL MONTANA LLC
Practice address: 1019 Hilda Ave
Missoula, MT 59801-4323
Phone: (406) 560-2170
NPI assigned: Aug 1, 2019
Organization subpart: No

Authorized official

Name: Thomas J McMahon, MD NPI 1558399709
Title: Owner of Asm
Phone: (406) 560-2170

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Thomas J McMahon, MD Surgery Physician · Anaconda, MT · NPI 1558399709

Medicare reassignment Authorized official MT · TX · WY

Medicare participation

Medicare fee-for-service enrollment: Enrolled (4 enrollments) in MT, WA, WY, TX

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20200903001271	MT	Part B Supplier - Clinic/Group Practice	6608293758	Receives reassigned benefits from 1 practitioner Practice locations: Missoula, MT
O20240422000721	WA	Part B Supplier - Clinic/Group Practice	6608293758	Practice locations: Bellingham, WA
O20240517001885	WY	Part B Supplier - Clinic/Group Practice	6608293758	Receives reassigned benefits from 1 practitioner Practice locations: Jackson, WY
O20240605001676	TX	Part B Supplier - Clinic/Group Practice	6608293758	Receives reassigned benefits from 1 practitioner Practice locations: Frisco, TX

National Provider Directory

Locations

12530 Lebanon Rd
Ste 205
Frisco, TX 75035
Phone (214) 269-5353

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinic/Center	261Q00000X			Yes

Addresses

Primary practice location

1019 Hilda Ave
Missoula, MT 59801-4323

Mailing address

1019 Hilda Ave
Missoula, MT 59801-4323
Phone (406) 560-2170

Other providers in Missoula, MT

All providers in Missoula, MT · Clinic/Center in Montana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2024. 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.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.