Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Tisevich, PA

Individual provider Physician Assistant · NPI 1811508914

Jacob Tisevich, PA is a Physician Assistant in Bozeman, Montana. Qualified in 2020, 6 years ago. Practices with Beacon Orthopaedics and Sports Medicine Ltd, a 471-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
6
Licensed in
OH
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3400 Laramie Dr
Bozeman, MT 59718-2005
Phone: (406) 587-0122
Fax: (844) 656-2480
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.006640RX (OH)

Record details

NPI number1811508914
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 12, 2020
Last updated in NPPESDecember 24, 2025
Certification dateDecember 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Beacon Orthopaedics And Sports Medicine Ltd — 471 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Bozeman