Kynzie Oliver, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0656 Issued in ND

Practice address

1301 15TH Ave W
Williston, ND 58801-3821

Phone

(701) 774-7400

NPI assigned

Sep 29, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kynzie Brown Former name

Medicare fee-for-service enrollment

Enrolled in MT, WY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Billings Dermatology PCGroup PAC ID 1951718170, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health St Vincent Regional Hospital Hospital, Billings, MT, CCN 270049

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Billings Dermatology PC

  • Dermatology Physician
  • Worland, WY
  • NPI 1902400690
  Medicare reassignment Care Compare group NPD
• Billings Dermatology PC

  • Dermatology Physician
  • Billings, MT
  • NPI 1881298560
  Medicare reassignment
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

• SCL Health Montana

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1083655997
  Care Compare affiliation
• St. Vincent Healthcare

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1396916276
  Care Compare affiliation

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1346799400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013800",
            "telephone_number": "170-572-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "KYNZIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1468996",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYNZIE",
            "last_name": "BROWN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Oelke
• Madison Jade Ofert
• Hannah Clark Oglesby
• Heidi Nicole Oien, FNP-C
• Danielle Olds
• Colleen Renea Olson
• Mark A Olson, MD
• Vikki Olson
• Dennis L Omvig, LSW
• Open Door Behavioral Health Services, PLLC

• Physician Assistant in Williston, ND
• Providers in Williston, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.