NPIMap

Individual provider Active NPI

Matthew T. Zemacke III, PA-C

  • Medical Physician Assistant
  • Kalispell, MT
National Provider Identifier
1366472698
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
521 Issued in MT
Practice address
245 Windward Way Ste 101
Kalispell, MT 59901-3385
Phone
(406) 756-8488
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 11

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 8

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kalispell Regional Medical Center Inc 422 clinicians

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

  • Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051
  • Logan Health - Whitefish Hospital, Whitefish, MT, CCN 271336

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
I20080401000751 MT Practitioner - Physician Assistant 4385609171 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051912PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center Inc CurrentSince Nov 16, 2015 Accepting new patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Nov 16, 2015 Accepting new patients
Bigfork Health and Wellness Inc Past Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients

Locations

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

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051912 PA
Medical Physician Assistant 363AM0700X 521 MT Primary

Addresses

NPPES NPI Registry

Primary practice location

245 Windward Way Ste 101
Kalispell, MT 59901-3385

Mailing address

160 Heritage Way
Suite 102
Kalispell, MT 59901-3161
Phone (406) 755-7785

Other practice location 1

160 Heritage Way
Suite 102
Kalispell, MT 59901-3161
Phone (406) 755-7785

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
900693OtherMTBCBS

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Healthcenter Northwest LLC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 27, 2023.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1366472698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY",
            "address_2": "SUITE 102",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013161",
            "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": "245 WINDWARD WAY STE 101",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013385",
            "telephone_number": "406-756-8488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Heritage Way",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013161",
            "country_code": "US",
            "telephone_number": "406-755-7785",
            "fax_number": "406-755-7857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEMACKE",
        "first_name": "MATTHEW",
        "middle_name": "T.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051912",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900693",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Healthcenter Northwest LLC",
            "address_1": "245 Windward Way",
            "address_2": "Suite 101",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.