NPIMap

Individual provider Active NPI

Ann Marie Bukacek, M.D.

  • Internal Medicine Physician
  • Kalispell, MT
National Provider Identifier
1295707776
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6869 Issued in MT
Practice address
160 Heritage Way
Ste. 102
Kalispell, MT 59901-3161
Phone
(406) 755-7785
Fax
(406) 755-7857
NPI assigned
Feb 7, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6869 MT Primary

Addresses

Primary practice location

160 Heritage Way
Ste. 102
Kalispell, MT 59901-3161

Mailing address

160 Heritage Way, Ste. 102
Kalispell, MT 59901-3127
Phone (406) 755-7785

Other identifiers 2

IdentifierTypeStateIssuer
0063665MedicaidMT
94705OtherMOBC/BS

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
I20040330001550 MT Practitioner - Internal Medicine 4385636521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Sunset PLZ
Kalispell, MT 59901-3660
Phone (406) 755-7785

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6869MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hosanna Health Care, P.C. Internal Medicine CurrentSince Aug 1, 2003 Accepting new patients

Locations

1 Sunset Plz
Kalispell, MT 59901
Phone (406) 755-7785

160 Heritage Way
Ste 102
Kalispell, MT 59901
Phone (406) 755-7785

Interoperability endpoints

  • Direct secure messaging: annie@3a707c3e.micromddirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295707776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY, STE. 102",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013127",
            "telephone_number": "406-755-7785",
            "fax_number": "406-755-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY",
            "address_2": "STE. 102",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013161",
            "telephone_number": "406-755-7785",
            "fax_number": "406-755-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKACEK",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "6869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063665",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "94705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.