DR. BRIAN T PELCZAR M.D.
NPI 1528004520
Otolaryngology in Billings, MT


Quality Rating: 92.04 out of 100 score

NPI Status: Active since June 20, 2006

Contact Information

2900 12TH AVE N
SUITE 350W
BILLINGS, MT
ZIP 59101
Phone: (406) 238-6161
Fax: (406) 238-6171

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  • Individual
  • Male
  • Years of Experience 38
  • Otolaryngology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About BRIAN PELCZAR

This page provides the complete NPI Profile along with additional information for Brian Pelczar, a provider established in Billings, Montana with a medical specialization in Otolaryngology and more than 38 years of experience. He graduated from Jefferson Medical College Of Thomas Jefferson University in 1988. The healthcare provider is registered in the NPI registry with number 1528004520 assigned on June 2006. The practitioner's primary taxonomy code is 207Y00000X with license number MT7342 (MT). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1528004520
Provider Name
DR. BRIAN T PELCZAR M.D.
Gender
Male
Entity Type
Individual
Location Address
2900 12TH AVE N SUITE 350W BILLINGS, MT 59101
Location Phone
(406) 238-6161
Location Fax
(406) 238-6171
Mailing Address
2900 12TH AVE N SUITE 350W BILLINGS, MT 59101
Mailing Phone
(406) 238-6161
Mailing Fax
(406) 238-6171
Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduation Year
1988
Is Sole Proprietor?
Yes
Enumeration Date
06-20-2006
Last Update Date
07-08-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Otolaryngology

Taxonomy Code
207Y00000X
Type
Allopathic & Osteopathic Physicians
License No.
MT7342
License State
MT
Taxonomy Description
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Y00000XAllopathic & Osteopathic Physicians

Otolaryngology

WY5324A (WY)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? 901 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • BlueSelect Bronze Basic - PPO
  • BlueSelect Bronze Core - PPO
  • BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
  • BlueSelect Gold Core - PPO
  • BlueSelect Gold HealthPlus - PPO
  • BlueSelect Gold Standard without Kid's Dental - PPO
  • BlueSelect Silver Classic - PPO
  • BlueSelect Silver Classic without Kid's Dental - PPO
  • BlueSelect Silver HealthPlus - PPO
  • BlueSelect Silver HealthPlus without Kid's Dental - PPO
  • Connect Bronze Expanded Standard - PPO
  • Connect Bronze HDHP - PPO
  • Connect Catastrophic - PPO
  • Connect Gold - PPO
  • Connect Gold Standard - PPO
  • Connect Silver - PPO
  • Connect Silver Standard - PPO
  • High Plains Bronze HDHP - PPO
  • High Plains Bronze Standard Expanded - PPO
  • High Plains Gold - PPO
  • Navigator Bronze 7000 Exchange - PPO
  • Navigator Bronze 9200 - PPO
  • Navigator Bronze HSA 8050 - PPO
  • Navigator Gold 1500 - PPO
  • Navigator Gold 1500 Exchange - PPO
  • Navigator Gold 500 Exchange - PPO
  • Navigator Silver 3500 Exchange - PPO
  • Navigator Silver 4000 Exchange - PPO
  • Navigator Silver 5000 - PPO
  • Navigator Silver HSA 3500 - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0000005861OTHER (01)MTMT BC/BS
F58941MEDICARE UPIN (02)MT 
0099047MEDICAID (05)MT 

Medicare Participation & PECOS Enrollment Status

Brian Pelczar is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Brian Pelczar is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6507965357

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090813000386, I20120224000479

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Ct scan of face without contrast

A CT scan of the face without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your face, including bones, soft tissues, and blood vessels. It's often used to diagnose diseases, injuries, or abnormalities. No contrast dye is used in this procedure.

This service was performed 20 times for 16 patients

Diagnostic exam of nasal passages using an endoscope

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

This service was performed 65 times for 40 patients

Diagnostic exam of voice box using a flexible endoscope

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

This service was performed 48 times for 46 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 33 times for 24 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 43 times for 42 patients

New patient office or other outpatient visit, 15-29 minutes

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

This service was performed 13 times for 13 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 135 times for 135 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 15 times for 15 patients

Removal of impacted ear wax

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

This service was performed 41 times for 34 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.63 for a new patient copayment and $17.7 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 59101 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $130.52
  • Minimum New Patient Price $56.81
  • Maximum New Patient Price $172.26
  • Average New Patient Copayment $32.63
  • Minimum New Patient Copayment $14.2
  • Maximum New Patient Copayment $43.06

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.82
  • Minimum Established Patient Price $18.24
  • Maximum Established Patient Price $140.32
  • Average Established Patient Copayment $17.7
  • Minimum Established Patient Copayment $4.56
  • Maximum Established Patient Copayment $35.08

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.04, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 92.04 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 78.2

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Brian Pelczar is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST VINCENT HEALTHCARE1233 N 30TH ST
BILLINGS, MT 59101
(406) 657-7000Acute Care Hospitals

Reviews for DR. BRIAN T PELCZAR M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1528004520
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
254800854
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 4 + 8 + 0 + 0 + 8 + 5 + 4 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1528004520 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1881696011DR. PAUL W. HOLLEY M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)2900 12TH AVE N STE 295W
BILLINGS, MT 59101
(406) 238-6360
1790787935YELLOWSTONE PATHOLOGY INSTITUTE, INC.
Organization
Clinical Medical Laboratory2900 12TH AVE N STE 295W
BILLINGS, MT 59101
(406) 238-6360
1770585903DR. DUANE A. SCHULTZ M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)2900 12TH AVE N STE 295W
BILLINGS, MT 59101
(406) 238-6360
1639171713DR. MICHAEL S. BROWN M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)2900 12TH AVE N STE 295W
BILLINGS, MT 59101
(406) 238-6360
1659376135 EDWARD N DEAN MD
Individual
Internal Medicine (Interventional Cardiology)2900 12TH AVE N STE 204E
BILLINGS, MT 59101
(406) 237-5001
1619972106MONTANA HEART INSTITUTE
Organization
Internal Medicine (Interventional Cardiology)2900 12TH AVE N STE 204E
BILLINGS, MT 59101
(406) 237-5001
1588669071 ROBERT T TERRY MD
Individual
Internal Medicine (Interventional Cardiology)2900 12TH AVE N STE 204E
BILLINGS, MT 59101
(406) 237-5001
1407852312 MICHAEL HENRY SCHABACKER MD
Individual
Physical Medicine & Rehabilitation (Pain Medicine)2900 12TH AVE N SUITE 335W
BILLINGS, MT 59101
(406) 237-8808
1053317776 FRED V SCHNEIDER M.D.
Individual
Surgery2900 12TH AVE N STE 502E
BILLINGS, MT 59101
(406) 245-6982
1750388609DR. JOHN R DORR M.D.
Individual
Orthopaedic Surgery2900 12TH AVE N #140 W
BILLINGS, MT 59101
(406) 237-5050
1255330791ANESTHESIA PARTNERS OF MONTANA PC
Organization
Specialist2900 12TH AVE N SUITE 205W
BILLINGS, MT 59101
(406) 254-0707
1932191632DR. THOMAS M COUNTWAY DPM
Individual
Podiatrist2900 12TH AVE N SUITE 140W
BILLINGS, MT 59101
(406) 238-6540
1194717959DR. JOSEPH M ERPELDING MD
Individual
Orthopaedic Surgery2900 12TH AVE N SUITE 140W
BILLINGS, MT 59101
(406) 238-6540
1356333132DR. JAMES F SCHWARTEN MD
Individual
Orthopaedic Surgery2900 12TH AVE N SUITE 140W
BILLINGS, MT 59101
(406) 238-6540
1962494666 TERRY G CALKINS OT CHT
Individual
Occupational Therapist2900 12TH AVE N SUITE 140W
BILLINGS, MT 59101
(406) 238-6540
1124010830 JOHN S ETCHART PA-C
Individual
Physician Assistant2900 12TH AVE N SUITE 305E.
BILLINGS, MT 59101
(406) 237-5750
1235121849DR. JAMES S ELLIOTT MD
Individual
Orthopaedic Surgery2900 12TH AVE N SUITE 140W
BILLINGS, MT 59101
(406) 238-6540
1457343063DR. JOHN R WILSON MD
Individual
Orthopaedic Surgery2900 12TH AVE N SUITE 140W
BILLINGS, MT 59101
(406) 238-6540
1952393514 MARK T SULLIVAN PA-C
Individual
Physician Assistant2900 12TH AVE N SUITE 140W
BILLINGS, MT 59101
(406) 238-6540
1942295134 FREDERICK WILLIAM KAHN M.D.
Individual
Internal Medicine (Pulmonary Disease)2900 12TH AVE N SUITE 300E
BILLINGS, MT 59101
(406) 238-6800

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528004520, enumerated in the NPI registry as an "individual" on June 20, 2006

The provider is located at 2900 12th Ave N Suite 350w Billings, Mt 59101 and the phone number is (406) 238-6161

The provider's speciality is Otolaryngology with taxonomy code 207Y00000X

The provider has more than 38 years of experience. He graduated from Jefferson Medical College Of Thomas Jefferson University in 1988.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $130.52 with an average copayment of $32.63 for new patient appointments. Established patients should expect a typical charge of $70.82 and an average copayment of 17.7. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Ct scan of face without contrast, Diagnostic exam of nasal passages using an endoscope, Diagnostic exam of voice box using a flexible endoscope, Established patient office or other outpatient visit, 10-19 minutes, Established patient office or other outpatient visit, 20-29 minutes, New patient office or other outpatient visit, 15-29 minutes, New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes and Removal of impacted ear wax.

The practitioner is affiliated to the following hospital(s): ST VINCENT HEALTHCARE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.