Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB TISEVICH, PA
ActiveJACOB TISEVICH, PA is a Physician Assistant healthcare provider located in BOZEMAN, Montana. NPI 1811508914 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · BOZEMAN, MT
Registration Details
- NPI Number
- 1811508914
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 12, 2020 (5.9950790455151 yrs)
- Last Updated
- Dec 24, 2025
- License
-
50.006640RX (OH)
Practice Information
- Address
-
3400 LARAMIE DRBOZEMAN, MT, 597182005Browse MT providers · Browse ZIP 59718
- Phone
- 4065870122
- Fax
- 8446562480
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in BOZEMAN, MT
| Name | Credential | NPI |
|---|---|---|
| TERESA A DUDZINSKI | PA-C | 1952395675 |
| SCOTT A GILL | PA-C | 1164417622 |
| MRS. JUSTINE M. DEROUSSE | PA-C | 1609843168 |
| MOZELLE M SOULE | PA-C | 1053372821 |
| JASON J LAWN | PA | 1316908825 |
| DEBORAH CADES | PA-C | 1306893102 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.