Individual provider Active NPI

Bradley Kevin Coots, MD

  • Plastic Surgery Physician
  • Missoula, MT
National Provider Identifier
1972611481
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MED-PHYS-LIC-76243 Issued in MT
Practice address
500 W Broadway St FL 4
Missoula, MT 59802-4008
Phone
(406) 329-5866
Fax
(406) 329-5864
NPI assigned
Aug 25, 2006
Last updated
May 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 39703 IA
Plastic and Reconstructive Surgery Physician 2086S0122X 27081 NE
Plastic Surgery Physician 208200000X 9162 SD
Plastic Surgery Physician 208200000X MED-PHYS-LIC-76243 MT Primary

Addresses

Primary practice location

500 W Broadway St FL 4
Missoula, MT 59802-4008

Mailing address

PO Box 31001-4110
Pasadena, CA 91110-4110
Phone (406) 327-3199

Other practice location 1

1500 W 22nd St Ste 101
Sioux Falls, SD 57105-1503
Phone (605) 328-0000

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
I20190809001235 MT Practitioner - Plastic and Reconstructive Surgery 7719983568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

900 N Orange St
Missoula, MT 59802-2951
Phone (406) 327-3199

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy41
Melanoma (skin cancer) excision37
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9162SDMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt CurrentSince Jan 13, 2025 Accepting new patients
RCHP Billings - Missoula LLC Current Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Aug 1, 2019 Accepting new patients
Providence Health & Services Mt CurrentSince Jan 13, 2025 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Aug 1, 2019 Accepting new patients
Microsurgical Transplantation Research Foundation Past Accepting new patients
Plastic Surgery Northwest PLLC Plastic Surgery Past Accepting new patients

Locations

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2833 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 542-6559

2835 Fort Missoula Rd
Ste 205
Missoula, MT 59804
Phone (406) 542-0391

500 W Broadway St
Fl 4
Missoula, MT 59802
Phone (406) 327-1900

500 W Broadway St
Ste 320
Missoula, MT 59802

900 N Orange St
Ste 205
Missoula, MT 59802
Phone (406) 327-1950

Interoperability endpoints

  • Direct secure messaging: bcoots@direct.communitymed.org
  • Direct secure messaging: bcoots3572031@wm.providencedirect.org

Organizations & group practices 8

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 4

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1972611481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4110",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104110",
            "telephone_number": "406-327-3199",
            "fax_number": "406-327-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST FL 4",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-329-5866",
            "fax_number": "406-329-5864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 W 22nd St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051503",
            "country_code": "US",
            "telephone_number": "605-328-0000",
            "fax_number": "605-328-0001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOTS",
        "first_name": "BRADLEY",
        "middle_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IA",
            "license": "39703",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NE",
            "license": "27081",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "SD",
            "license": "9162",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MT",
            "license": "MED-PHYS-LIC-76243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.