Kymberly M Tart, PA-C
Individual provider Active NPI Medical Physician Assistant · Dillon, MT
NPI 1154530756 · NPPES record last updated Oct 21, 2020
Key facts
- NPI
- 1154530756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 004137 (GA)
- Practice address
- 600 Mt Highway 91 S
Dillon, MT 59725-7379 - Phone
- (406) 683-3000
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Barrett Hospital Development Corporation
Practice addresses (Care Compare)
30 Mt Hwy 91 S
Dillon, MT 59725-3535
Phone (406) 683-1188
600 Mt Hwy 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000
Hospital & facility affiliations
- Barrett Hospital & Healthcare
- Bozeman Health Deaconess Hospital
- Barrett Hospital & Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080208000133 | GA | Practitioner - Physician Assistant | 4183707508 | Reassigns benefits to 1 organization |
| I20170323001126 | MT | Practitioner - Physician Assistant | 4183707508 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004137 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barrett Hospital Development Corporation | Current |
Accepting new patients | |
| Barrett Hospital Development Corporation | Current |
Accepting new patients | |
| Gainesville Heart and Vascular Group PC | Past | Accepting new patients |
Locations
600 MT Highway 91 S
Dillon, MT 59725
Phone (406) 683-3001
30 MT Highway 91 S
Dillon, MT 59725
Phone (406) 414-5070
Interoperability endpoints
- https://api.platform.athenahealth.com/7421/brand/1/csg/1/fhir/r4
- ktart750220@wm.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 004137 | GA | Yes |
Addresses
Primary practice location
600 Mt Highway 91 S
Dillon, MT 59725-7379
Mailing address
601 S. Enota Drive
Suite Q
Gainesville, GA 30501
Phone (770) 533-8420
Other practice location 1
743 Spring St.
Gainesville, GA 30501
Phone (770) 535-3553
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | KTART750220@WM.PROVIDENCEDIRECT.ORG |
Other providers in Dillon, MT
- Catherine Stewart
- Stoic Minds, PLLC
- Sunnyside Therapy PLLC
- Sweet Medicine Therapy LLC
- Sweetwater Dillon Opco LLC
- Katherine A Tetrault
- The Legacy Assisted Living LLC
- The Notch PT and Wellness LLC
- Tara Marie Thompson
- Thrive and Grow Speech Therapy, PLLC
All providers in Dillon, MT · Medical Physician Assistant in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.