Individual provider Active NPI

Angela Lemire, PA-C

  • Physician Assistant
  • Polson, MT
National Provider Identifier
1023716362
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MED-PAC-LIC-120273 Issued in MT
Practice address
6 13TH Ave E
Polson, MT 59860-5315
Phone
(406) 883-5680
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MED-PAC-LIC-120273 MT Primary

Addresses

Primary practice location

6 13TH Ave E
Polson, MT 59860-5315

Mailing address

6 13TH Ave E
Polson, MT 59860-5315

Other practice location 1

63351 US Highway 93
Ronan, MT 59864-2702
Phone (406) 676-5680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230526000162 MT Practitioner - Physician Assistant 5991161481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence St Joseph Medical CenterGroup PAC ID 0446230247, 52 clinicians

Practice addresses (Care Compare)

6 13TH Ave E
Polson, MT 59860-5315
Phone (406) 883-5377

63351 US Hwy 93
Ronan, MT 59864-2702
Phone (406) 676-5680

Hospital & facility affiliations

  • Providence St Joseph Medical Center Hospital, Polson, MT, CCN 271343
  • St Luke Community Hospital Hospital, Ronan, MT, CCN 271325
  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MED-PAC-LIC-120273MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence St Joseph Medical Center CurrentSince May 8, 2023 Accepting new patients
Credena Health LLC CurrentSince May 8, 2023 Accepting new patients

Locations

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

63351 US Highway 93
Ronan, MT 59864
Phone (406) 676-5680

Interoperability endpoints

  • Direct secure messaging: alemire924647@wm.providencedirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1023716362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63351 US Highway 93",
            "address_purpose": "LOCATION",
            "city": "Ronan",
            "state": "MT",
            "postal_code": "598642702",
            "country_code": "US",
            "telephone_number": "406-676-5680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMIRE",
        "first_name": "ANGELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-120273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

Verify at the official NPI Registry.