Kevin R Pancich, DPT ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1939PT Issued in MT

Practice address

1532 Ellis Street
Ste 201
Bozeman, MT 59715

Phone

(406) 587-4501

Fax

(406) 587-3919

NPI assigned

Jul 15, 2006

Last updated

Jan 7, 2008By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Performance and Rehabilitation Services IncGroup PAC ID 8820069156, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Advanced Performance & Rehabilitation Services Inc

  • Physical Therapy Clinic/Center
  • Bozeman, MT
  • NPI 1326064916

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1356367940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 ELLIS STREET",
            "address_2": "STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-587-4501",
            "fax_number": "406-587-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 ELLIS STREET",
            "address_2": "STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-587-4501",
            "fax_number": "406-587-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCICH",
        "first_name": "KEVIN",
        "middle_name": "R",
        "credential": "DPT ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1939PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401788",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00328588",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benedict F Painter, MD
• Amy K Pakula, DPT
• Dani Lynn Pallardy, PA-C
• Bethany Palmer, MSW, LCSW
• Lisa Michelle Palomaki, PT, DPT
• Marlisa Ann Papp, LAC
• Lindy Kurz Paradise, M.D.
• Pari Passu Counseling
• Park Clinic OB-GYN
• Reva Parker

• Physical Therapist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.