Individual provider Active NPI

Maile Christine Macaluso

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1366914335
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NUR-APRN-LIC-242966 Issued in MT
Practice address
3075 N Reserve St Ste Q
Missoula, MT 59808-1390
Phone
(406) 327-1750
Fax
(406) 327-1960
NPI assigned
Jan 1, 2019
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NUR-APRN-LIC-242966 MT Primary
Registered Nurse 163W00000X NUR-RN-LIC-48315 MT

Addresses

Primary practice location

3075 N Reserve St Ste Q
Missoula, MT 59808-1390

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (406) 327-1750

Other practice location 1

900 N Orange St
Missoula, MT 59802-2998
Phone (406) 329-5776

Other names 1

  • Maile Christine Nunes Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241016004100 MT Practitioner - Nurse Practitioner 6507398492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

3075 N Reserve St
Suite Q
Missoula, MT 59808-1390
Phone (406) 327-1850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-242966MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt CurrentSince Nov 3, 2024 Accepting new patients
Providence Health & Services Mt CurrentSince Nov 3, 2024 Accepting new patients

Locations

3075 N Reserve St
Ste Q
Missoula, MT 59808
Phone (406) 327-1750

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

900 N Orange St
Missoula, MT 59802
Phone (406) 327-3300

Interoperability endpoints

  • Direct secure messaging: mmacaluso928549@wm.providencedirect.org

Organizations & group practices 3

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 4

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": "1546300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1366914335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "406-327-1750",
            "fax_number": "406-327-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 N RESERVE ST STE Q",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081390",
            "telephone_number": "406-327-1750",
            "fax_number": "406-327-1960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 N Orange St",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598022998",
            "country_code": "US",
            "telephone_number": "406-329-5776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACALUSO",
        "first_name": "MAILE",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-01",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-242966",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "NUR-RN-LIC-48315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAILE",
            "last_name": "NUNES",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.