Individual provider Active NPI

Susan E. Cerovski, PA

  • Physician Assistant
  • Billings, MT
National Provider Identifier
1891771622
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MED-PAC-LIC-36129 Issued in MT
Practice address
1020 N 27TH St
Billings, MT 59101-0760
Phone
(406) 238-2500
NPI assigned
Dec 22, 2005
Last updated
Dec 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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-36129 MT Primary

Addresses

Primary practice location

1020 N 27TH St
Billings, MT 59101-0760

Mailing address

PO Box 35100
Billings, MT 59107-5100

Other identifiers 2

IdentifierTypeStateIssuer
977217MedicaidAZ
P00457896OtherAZRAILROAD MEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121002429 MT Practitioner - Physician Assistant 0143240705 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Montana LLCGroup PAC ID 8426489741, 7 clinicians

Practice addresses (Care Compare)

3528 Gabel Rd
Billings, MT 59102-7307
Phone (406) 373-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3333AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group - Billings, LLC CurrentSince Jun 1, 2017 Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Jun 1, 2017 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

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

3011 American Way
Missoula, MT 59808
Phone (406) 546-8745

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1891771622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35100",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591075100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N 27TH ST",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010760",
            "telephone_number": "406-238-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEROVSKI",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-36129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "977217",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00457896",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.