Individual provider Active NPI

Richelle A Stillwagon, MD

  • Ophthalmology Physician
  • Missoula, MT
National Provider Identifier
1164783544
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
104726 Issued in MT
Practice address
2687 Palmer St Ste C2
Missoula, MT 59808-1710
Phone
(406) 728-0044
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R73383 AZ
Ophthalmology Physician 207W00000X MD60894494 WA
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 104726 MT Primary

Addresses

Primary practice location

2687 Palmer St Ste C2
Missoula, MT 59808-1710

Mailing address

6150 Cochise Dr
Missoula, MT 59804-9720
Phone (602) 743-5967

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220531001230 MT Practitioner - Ophthalmology 7810209178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montana Valley Eye Clinic, PLLCGroup PAC ID 3577607571, 2 clinicians

Practice addresses (Care Compare)

2687 Palmer St
Suite C2
Missoula, MT 59808-1710
Phone (406) 728-0044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.71 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R73383AZMDInternal Medicine Physician
104726MTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montana Valley Eye Clinic, PLLC Single Specialty CurrentSince Apr 14, 2022 Accepting new patients

Locations

2687 Palmer St
Ste C2
Missoula, MT 59808
Phone (406) 728-0044

Organizations & group practices 1

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 4

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1164783544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 COCHISE DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598049720",
            "telephone_number": "602-743-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2687 PALMER ST STE C2",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081710",
            "telephone_number": "406-728-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWAGON",
        "first_name": "RICHELLE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R73383",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD60894494",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MT",
            "license": "104726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.