MISSION VALLEY HEALTH CLINIC, INCORPORATED — NPI 1982659652 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical in ST IGNATIUS, MT)

CMS-1500 Box 24J / 33a • NPI

1982659652

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

363AM0700X (CMS 97)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical

Box 32 Service Location & ZIP+4

35773 AIRPORT RD, ST IGNATIUS, MT, 59865-9001

✓ 9-Digit EDI 837 ZIP+4 (59865-9001)

Practice Phone & Referral Fax

(406) 745-8765

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1982659652 (MISSION VALLEY HEALTH CLINIC, INCORPORATED) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1982659652` (NPI-2 Organization / Facility)
Provider / Legal Name	MISSION VALLEY HEALTH CLINIC, INCORPORATED
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical NUCC Code: `363AM0700X` (Physician Assistant, Medical)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	35773 AIRPORT RD, ST IGNATIUS, MT, 59865-9001
Practice Telephone / Fax	Tel: (406) 745-8765
Administrative Mailing Address	35773 AIRPORT RD, ST IGNATIUS, MT, 59865-9001
Enumeration & Last Sync	Enumerated: 2006-05-23 \| CMS Record Updated: 2009-03-11
Authorized Official	SABRINA CASTOR (Office Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

35773 AIRPORT RD, ST IGNATIUS, MT, 59865-9001

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Plain-English Taxonomy & CMS Crosswalk (363AM0700X)

What Does Taxonomy Code 363AM0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AM0700X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 97 (Physician Assistant)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Physician Assistant, Medical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MISSION VALLEY HEALTH CLINIC, INCORPORATED)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363AM0700X` — Physician Assistant, Medical Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical	State: MT \| License: `145` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MISSION VALLEY HEALTH CLINIC, INCORPORATED (NPI #1982659652)