Charlene Pontoriero, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

23960 Issued in MT

Practice address

107 Dilworth St
Glendive, MT 59330-2053

Phone

(406) 345-8935

Fax

(406) 345-8908

NPI assigned

Nov 17, 2006

Last updated

Dec 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ND, MT2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Gabert Medical Services, Inc

  dba Gabert Clinic

  • Multi-Specialty Clinic/Center
  • Glendive, MT
  • NPI 1336158930
  Medicare reassignment NPD
• Sidney Health Center

  • Critical Access Hospital
  • Sidney, MT
  • NPI 1285719161
  Medicare reassignment NPD
• Sidney Health Center

  dba Sidney Health Center Clinic

  • Clinic/Center
  • Sidney, MT
  • NPI 1376617191
  Medicare reassignment NPD
• Williston Radiology Consultants PC

  dba Fairlight Medical Center

  • Specialist
  • Williston, ND
  • NPI 1942375852
  Medicare reassignment NPD
• Sidney Health Center

  dba Clinic Pharmacy

  • Community/Retail Pharmacy
  • Sidney, MT
  • NPI 1497743959
  NPD
• Sidney Health Center

  • Emergency Care Clinic/Center
  • Sidney, MT
  • NPI 1568532802
  NPD
• Fairlight Medical Center

  • Urgent Care Clinic/Center
  • Williston, ND
  • NPI 1811162811
  NPD
• Frances Mahon Deaconess Hospital

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

  dba Sidney Health Center Hospice

  • Community Based Hospice Care Agency
  • Sidney, MT
  • NPI 1932160413
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1457424244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8935",
            "fax_number": "406-345-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8935",
            "fax_number": "406-345-8908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 14th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Sidney",
            "state": "MT",
            "postal_code": "592703521",
            "country_code": "US",
            "telephone_number": "406-488-3963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONTORIERO",
        "first_name": "CHARLENE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "23960",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R30872",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MT",
            "identifier": "000063062",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0720161",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005027",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpontoriero12989546@drect.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "214 14th Ave SW",
            "city": "Sidney",
            "state": "MT",
            "country_code": "US",
            "postal_code": "592703521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David L Nieman, PA-C
• Teresea Olson, PA-C
• Nena Panasuk, DO
• Brittany Pesik, RD
• Plains Synergy Healthcare PLLC
• Chrystal Lynn Potter, M.D.
• Prairie View Special Services
• April Dawn Price, NURSE PRACTITIONER
• Falecia Rader, FNP-C
• Ruthann Rafacz, NP

• Nurse Practitioner in Glendive, MT
• Providers in Glendive, MT by specialty
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.