NPIMap

Individual provider Active NPI

Stephen E Humpal, DO

  • Family Medicine Physician
  • Seeley Lake, MT
National Provider Identifier
1760740666
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80096 Issued in MT
Practice address
3050 Mt Highway 83 N
Seeley Lake, MT 59868-8620
Phone
(406) 677-2277
NPI assigned
Apr 27, 2012
Last updated
Dec 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 80096 MT Primary

Addresses

Primary practice location

3050 Mt Highway 83 N
Seeley Lake, MT 59868-8620

Mailing address

PO Box 399
214 S 4TH St
Kremmling, CO 80459-0399
Phone (970) 724-3442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160329000872 CO Practitioner - Family Practice 0840597340 Reassigns benefits to 1 organization
I20200122001011 MT Practitioner - Family Practice 0840597340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Granby Park Dr S
Granby, CO 80446-5304
Phone (970) 724-3442

214 S 4TH St
Kremmling, CO 80459-0399
Phone (970) 724-3442

400 Grand Ave
Kremmling, CO 80459-0399
Phone (970) 724-3524

P O Box
Kremmling, CO 80459-0399

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.61 of 100Reported as group
Quality
76.83
Promoting interoperability
100
Improvement activities
40
Cost
35.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80096MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kremmling Memorial Hospital District CurrentSince Feb 17, 2016 Accepting new patients
Partnership Health Center Inc Family Medicine Current Accepting new patients
Partnership Health Center Inc CurrentSince Dec 16, 2019 Accepting new patients
Kremmling Memorial Hospital District CurrentSince Feb 17, 2016 Accepting new patients
Partnership Health Center Inc CurrentSince Dec 16, 2019 Accepting new patients

Locations

1000 Granby Park Dr S
Granby, CO 80446
Phone (970) 668-5771

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

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 7

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1760740666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "address_2": "214 S 4TH ST",
            "city": "KREMMLING",
            "state": "CO",
            "postal_code": "804590399",
            "telephone_number": "970-724-3442",
            "fax_number": "970-724-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MT HIGHWAY 83 N",
            "city": "SEELEY LAKE",
            "state": "MT",
            "postal_code": "598688620",
            "telephone_number": "406-677-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPAL",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "80096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seeley Lake, MT

Sources for this page

Verify at the official NPI Registry.