NPIMap

Organization Active NPI

Bozeman Health Big Sky Medical Center, LLC

  • Family Medicine Physician
  • Big Sky, MT
National Provider Identifier
1740659952
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BOZEMAN HEALTH BIG SKY MEDICAL CENTER, LLC
Practice address
334 Town Center Avenue
Big Sky, MT 59716
Phone
(406) 995-6995
Fax
(406) 995-6999
NPI assigned
Sep 17, 2015
Last updated
Oct 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Authorized official

Name
Angie Libertini
Title
Payer Enrollment Supervisor
Phone
(406) 414-1958

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

334 Town Center Avenue
Big Sky, MT 59716

Mailing address

915 Highland Blvd
Attention - PFS
Bozeman, MT 59715-6902
Phone (406) 414-5000

Other practice location 1

83 Beaverhead Trail
Big Sky, MT 59716
Phone (406) 995-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151023000110 MT Part B Supplier - Clinic/Group Practice 7315256872 Receives reassigned benefits from 110 practitioners
Practice locations: Big Sky, MT

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 111

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 111

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1740659952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "address_2": "ATTENTION - PFS",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 TOWN CENTER AVENUE",
            "city": "BIG SKY",
            "state": "MT",
            "postal_code": "59716",
            "telephone_number": "406-995-6995",
            "fax_number": "406-995-6999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "83 Beaverhead Trail",
            "address_purpose": "LOCATION",
            "city": "Big Sky",
            "state": "MT",
            "postal_code": "59716",
            "country_code": "US",
            "telephone_number": "406-995-6650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOZEMAN HEALTH BIG SKY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "LIBERTINI",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "PAYER ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "406-414-1958"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Sky, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.