Alexis Vantiem, is a medicare enrolled "Physician Assistant" in Superior, Montana. Her current practice location is
1208 6th Ave, Superior, Montana. You can reach out to her office (for appointments etc.) via phone at
(406) 822-4841.
Alexis Vantiem is licensed to practice in Montana (license number MED-PAC-LIC-145618) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124706627.
Provider's Profile
Full Name | Alexis Vantiem |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 1208 6th Ave, Superior, Montana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1124706627
- Provider Enumeration Date: 07/06/2023
- Last Update Date: 01/14/2025
Medicare PECOS Information:
- PECOS PAC ID: 5496284374
- Enrollment ID: I20250122000779
Medical Identifiers
Medical identifiers for Alexis Vantiem such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124706627 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | MED-PAC-LIC-145618 (Montana) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alexis Vantiem is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Alexis Vantiem, 1208 6th Ave, Superior, MT 59872-9667 Ph: (406) 822-4841 | Alexis Vantiem, 1208 6th Ave, Superior, MT 59872-9667 Ph: (406) 822-4841 |
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