Individual provider Active NPI

Brian Kenneth Landsverk, MD

  • Gastroenterology Physician
  • Bozeman, MT
National Provider Identifier
1821182627
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
8647 Issued in MT
Practice address
915 Highland Blvd
Bozeman, MT 59715-6902
Phone
(406) 586-3309
Fax
(406) 522-8498
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 8647 MT Primary

Addresses

Primary practice location

915 Highland Blvd
Bozeman, MT 59715-6902

Mailing address

1125 East Babcock
Bozeman, MT 59715
Phone (406) 580-7642

Other identifiers 2

IdentifierTypeStateIssuer
000097121OtherMTBLUE CROSS BLUE SHIELD
0039695MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090323000390 MT Practitioner - Gastroenterology 1759448558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of North Dakota School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Falls Clinic LLCGroup PAC ID 8325944499, 73 clinicians

Practice addresses (Care Compare)

3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.98 of 100Reported as apm
Quality
80.39
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy49
Upper gastrointestinal (GI) endoscopy for acid reflux27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8647MTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Falls Clinic LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

3010 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3095

3000 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3102

1400 29th St S
Great Falls, MT 59405
Phone (406) 442-3570

Interoperability endpoints

  • Direct secure messaging: brian.landsverk.1@25095.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25095/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1821182627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 EAST BABCOCK",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-580-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-586-3309",
            "fax_number": "406-522-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDSVERK",
        "first_name": "BRIAN",
        "middle_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "8647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000097121",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0039695",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.