Individual provider Active NPI

Benjamin Malmanger, OD

  • Optometrist
  • Missoula, MT
National Provider Identifier
1992634729
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-OPT-LIC-5893 Issued in MT
Practice address
700 W Kent Ave
Missoula, MT 59801-6772
Phone
(406) 541-3937
Fax
(406) 541-3811
NPI assigned
May 18, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-OPT-LIC-5893 MT Primary

Addresses

Primary practice location

700 W Kent Ave
Missoula, MT 59801-6772

Mailing address

700 W Kent Ave
Missoula, MT 59801-6772
Phone (406) 541-3937

Other practice location 1

120 S 5th St Ste 104
Hamilton, MT 59840-2798
Phone (406) 363-3366

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260626002791 MT Practitioner - Optometry 7214400522

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocky Mountain Eye Center PCGroup PAC ID 7416986542, 16 clinicians

Practice addresses (Care Compare)

700 W Kent Ave
Missoula, MT 59801-6772
Phone (406) 541-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-OPT-LIC-5893MTMDOptometrist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1992634729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W KENT AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016772",
            "telephone_number": "406-541-3937",
            "fax_number": "406-541-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W KENT AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016772",
            "telephone_number": "406-541-3937",
            "fax_number": "406-541-3811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S 5th St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "MT",
            "postal_code": "598402798",
            "country_code": "US",
            "telephone_number": "406-363-3366",
            "fax_number": "406-541-3811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALMANGER",
        "first_name": "BENJAMIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "OPT-OPT-LIC-5893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.