Individual provider Active NPI

Stephen Hisey, PT

  • Orthopedic Physical Therapist
  • Bozeman, MT
National Provider Identifier
1790877439
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
633PT Issued in MT
Practice address
1700 W Koch St
Suite 12
Bozeman, MT 59715-4148
Phone
(406) 587-6057
NPI assigned
Sep 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 633PT MT Primary

Addresses

Primary practice location

1700 W Koch St
Suite 12
Bozeman, MT 59715-4148

Mailing address

1700 W Koch St
Suite 12
Bozeman, MT 59715-4148

Other identifiers 2

IdentifierTypeStateIssuer
3401139MedicaidMT
61058OtherMTBLUE CROSS/BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
633PTMTMDOrthopedic Physical Therapist
633MTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Performance & Rehabilitation Services Inc Orthopedic PastSince Jan 1, 1999 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790877439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W KOCH ST",
            "address_2": "SUITE 12",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597154148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W KOCH ST",
            "address_2": "SUITE 12",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597154148",
            "telephone_number": "406-587-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISEY",
        "first_name": "STEPHEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MT",
            "license": "633PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401139",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHEILD",
            "identifier": "61058",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.