Individual provider Active NPI

Weston Tardy, MD

  • Emergency Medicine Physician
  • Missoula, MT
National Provider Identifier
1730684606
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD61156257 Issued in WA
Practice address
500 W Broadway St
Missoula, MT 59802-4008
Phone
(406) 329-5635
Fax
(406) 327-2160
NPI assigned
Mar 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD24026 ME
Emergency Medicine Physician 207P00000X MED-PHYS-LIC-94961 MT
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X MD61156257 WA Primary

Addresses

Primary practice location

500 W Broadway St
Missoula, MT 59802-4008

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (406) 329-5635

Other practice location 1

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-0111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wtardy1653042@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210608003273 AK Practitioner - Emergency Medicine 4082031331 Reassigns benefits to 2 organizations
I20220414002463 WA Practitioner - Emergency Medicine 4082031331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denali Emergency Medicine Assoc PCGroup PAC ID 0042102287, 21 clinicians

Practice addresses (Care Compare)

2801 Debarr Rd
Anchorage, AK 99508-2932
Phone (907) 264-1222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.98
Improvement activities
40
Cost
82.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Emergency Medicine Associates Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Northwest Observation Associates PC CurrentSince Apr 15, 2022 Accepting new patients
Denali Emergency Medicine Assoc PC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

2801 Debarr Rd
Anchorage, AK 99508
Phone (907) 264-1222

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1521849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1730684606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "406-329-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-329-5635",
            "fax_number": "406-327-2160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARDY",
        "first_name": "WESTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-24",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD24026",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-94961",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61156257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtardy1653042@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 W Broadway St",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598024008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.