Jesse N Bostrom, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-7526 Issued in ID

Practice address

1302 Prospect Ave Ste C
Helena, MT 59601-3928

Phone

(406) 502-1900

Fax

(406) 502-1333

NPI assigned

Aug 31, 2021

Last updated

Aug 31, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Big Sky Health & Rehab LLC

  dba Peak Physical Therapy & Sports Rehab

  • Physical Therapist
  • Helena, MT
  • NPI 1033583273
  Medicare reassignment NPD

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1952079543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-300-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 PROSPECT AVE STE C",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596013928",
            "telephone_number": "406-502-1900",
            "fax_number": "406-502-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTROM",
        "first_name": "JESSE",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne M Boone, OTR/R
• Boshart Physical Therapy PLLC (Ability Physical Therapy PLLC)
• Haley Kay Boshart, PT, DPT
• Alex Bostrom, SWLC
• Carley Bostrom
• Daniel Craig Bothwell, D.O.
• Martha Bottelson, LCPC
• Justin Bouma, DO
• Cheryl Jenavieve Bouvier, LCSW RPTS
• Boyd Andrew Community Services

• Physical Therapist in Helena, MT
• Providers in Helena, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.