Mercury Street Medical Group PLLC
NPI 1619054681ActiveOrganization· Physician Assistant· Butte, MT
Physician Assistant in Butte, Montana, registered in NPPES in November 2006. The authorized official on file is Scott G. Butler, Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1619054681 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 1, 2006 |
| Last updated in NPPES | May 18, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 1074257 | MT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MT) |
|---|
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