Tanner Ryan Staley

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

104 Rufus LN
Polson, MT 59860-8903

Phone

(406) 883-2555

Fax

(406) 883-2559

NPI assigned

Jul 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Community HospitalGroup PAC ID 5496659567, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Partners in Home Care Inc Home health agency, Missoula, MT, CCN 277032
• St Luke Community Hospital Hospital, Ronan, MT, CCN 271325

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• St Lukes Community Hospital

  • Critical Access Hospital
  • Ronan, MT
  • NPI 1336213446
  Medicare reassignment Care Compare group NPD
• St. Lukes Community Hospital

  • Rural Health Clinic/Center
  • St. Ignatius, MT
  • NPI 1306911169
  Medicare reassignment
• St Lukes Community Hospital

  • Urgent Care Clinic/Center
  • Ronan, MT
  • NPI 1154566271
  NPD
• St Lukes Community Hospital

  • Certified Registered Nurse Anesthetist
  • Ronan, MT
  • NPI 1518663608
  NPD
• St. Lukes Community Hospital

  • Rural Health Clinic/Center
  • Polson, MT
  • NPI 1184785420
  NPD (past)

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

• Partners in Home Care, Inc.

  • Home Health Agency
  • Missoula, MT
  • NPI 1629135447
  Care Compare affiliation
• St Lukes Community Hospital

  • Critical Access Hospital
  • Ronan, MT
  • NPI 1336213446
  Care Compare affiliation

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1225764541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 RUFUS LN",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608903",
            "telephone_number": "406-883-2555",
            "fax_number": "406-883-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 RUFUS LN",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608903",
            "telephone_number": "406-883-2555",
            "fax_number": "406-883-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "TANNER",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Lukes Community Hospital
• St Patricks Hospital and Health Sciences Center
• Marcia Lynn St. Goddard, DPT, CSCS
• St. Luke Community Hospital
• St. Lukes Community Hospital
• Penny Lynn Starkel, NP
• Tania Stevens, OT
• Craig Lyle Stevenson, LCSW
• Paige J Stone, PHARMD
• Vince Stone, RPH

• Physician Assistant in Polson, MT
• Providers in Polson, MT by specialty
• Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.