NPIMap

Individual provider Active NPI

Elizabeth Brakebush

  • Physician Assistant
  • Billings, MT
National Provider Identifier
1780005074
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MED-PAC-LIC-27741 Issued in MT
Practice address
1233 N 30TH St
Billings, MT 59101-0127
Phone
(406) 237-4141
Fax
(406) 237-4126
NPI assigned
Jan 3, 2014
Last updated
Jan 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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 MED-PAC-LIC-27741 MT Primary

Addresses

Primary practice location

1233 N 30TH St
Billings, MT 59101-0127

Mailing address

1233 N 30TH St
Billings, MT 59101-0127
Phone (406) 237-4141

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
I20140423001610 MT Practitioner - Physician Assistant 5799918900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rosebud Community Hospital IncGroup PAC ID 3375454168, shared by 3 NPIs, 8 clinicians

Practice addresses (Care Compare)

1144 N Broadway
Suite C
Billings, MT 59101-0115
Phone (406) 238-6380

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

383 17TH Ave N
Rosebud Healthcare Center
Forsyth, MT 59327-0268
Phone (406) 346-2161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-PAC-LIC-27741MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group - Billings, LLC CurrentSince Feb 28, 2015 Accepting new patients
SCL Health Montana Current Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Feb 28, 2015 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1144 N Broadway
Ste C
Billings, MT 59101
Phone (406) 238-6380

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

1233 N 30th St
Ofc
Billings, MT 59101

2900 12th Ave N
Ste 500E
Billings, MT 59101
Phone (406) 238-6380

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

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, 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": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1780005074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 N 30TH ST",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010127",
            "telephone_number": "406-237-4141",
            "fax_number": "406-237-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 N 30TH ST",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010127",
            "telephone_number": "406-237-4141",
            "fax_number": "406-237-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKEBUSH",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-27741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.