NPIMap

Individual provider Active NPI

Mary E. Tucker, PA-C

  • Physician Assistant
  • Billings, MT
National Provider Identifier
1750492021
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
461 Issued in MT
Practice address
1101 N 27TH St
Suite F
Billings, MT 59101-0101
Phone
(406) 325-5555
Fax
(406) 325-5556
NPI assigned
Aug 31, 2006
Last updated
Mar 17, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 461 MT Primary

Addresses

Primary practice location

1101 N 27TH St
Suite F
Billings, MT 59101-0101

Mailing address

1101 N 27TH St
Suite F
Billings, MT 59101-0101
Phone (406) 325-5555

Other identifiers 1

IdentifierTypeStateIssuer
0000901703OtherMTBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060911000546 MT Practitioner - Physician Assistant 1456303379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1233 N 30TH St
Billings, MT 59101-0127
Phone (406) 237-3913

16 N Miles Ave
Suite 101
Hardin, MT 59034-2356
Phone (406) 237-8270

2900 12TH Ave N
Suite 204E
Billings, MT 59101-7502
Phone (406) 237-5001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group - Billings, LLC CurrentSince Apr 10, 2024 Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Apr 10, 2024 Accepting new patients
SCL Health Medical Group - Billings LLC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
SCL Health Montana Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

2019 Broadwater Ave
Billings, MT 59102
Phone (406) 237-5200

2900 12th Ave N
Ste 204E
Billings, MT 59101
Phone (406) 237-5001

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

Organizations & group practices 5

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

Hospital & facility affiliations 8

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1750492021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N 27TH ST",
            "address_2": "SUITE F",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010101",
            "telephone_number": "406-325-5555",
            "fax_number": "406-325-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N 27TH ST",
            "address_2": "SUITE F",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010101",
            "telephone_number": "406-325-5555",
            "fax_number": "406-325-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MARY",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0000901703",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.