NPIMap

Individual provider Active NPI

Tessa Caitlin Skotnicki, PA

  • Medical Physician Assistant
  • Kalispell, MT
National Provider Identifier
1184989634
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
57605 Issued in MT
Practice address
320 Sunnyview LN
Kalispell, MT 59901-3129
Phone
(406) 752-7441
Fax
(406) 257-0304
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 574 WV
Medical Physician Assistant 363AM0700X PA2013-0093 NM
Medical Physician Assistant 363AM0700X 57605 MT Primary

Addresses

Primary practice location

320 Sunnyview LN
Kalispell, MT 59901-3129

Mailing address

320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 752-7441

Other identifiers 1

IdentifierTypeStateIssuer
75658071MedicaidNM

Other names 1

  • Tessa Caitlin Beitzel Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org HealthCenter Northwest, L.L.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170508002309 MT Practitioner - Physician Assistant 8224285556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-6725

320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 756-3526

350 Heritage Way
Kalispell, MT 59901-3167

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
574WVMDMental Health Counselor
57605MTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center, Inc CurrentSince May 1, 2017 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince May 1, 2017 Accepting new patients
Healthcenter Northwest, L.L.C. Past Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients
Advanced Gastroenterology Associates Past Accepting new patients

Locations

801 N 29th St
Billings, MT 59101
Phone (406) 238-2210

202 Conway Dr
Ste 100
Kalispell, MT 59901
Phone (406) 751-5666

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

320 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 752-7441

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

75 Claremont St
Ste F
Kalispell, MT 59901
Phone (406) 751-6549

245 Windward Way
Ste 101
Kalispell, MT 59901
Phone (406) 756-8488

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDJDBA

Organizations & group practices 6

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 7

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1184989634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOTNICKI",
        "first_name": "TESSA",
        "middle_name": "CAITLIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "574",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2013-0093",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "57605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75658071",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "HealthCenter Northwest, L.L.C.",
            "address_1": "320 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TESSA",
            "last_name": "BEITZEL",
            "middle_name": "CAITLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.