NPIMap

Individual provider Active NPI

Kyle J Tubbs, M.D.

  • Otolaryngology Physician
  • Kalispell, MT
National Provider Identifier
1487818944
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
TRN12195 Issued in FL
Practice address
160 Heritage Way
Kalispell, MT 59901-3102
Phone
(406) 752-8330
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X TRN12195 FL Primary

Addresses

Primary practice location

160 Heritage Way
Kalispell, MT 59901-3102

Mailing address

160 Heritage Way
Kalispell, MT 59901-3102
Phone (406) 752-8330

Other identifiers 3

IdentifierTypeStateIssuer
TRN12195OtherFLFLORIDA MEDICAL LICENSE
1487818944MedicaidMT
22321OtherMTMT STATE LICENSE

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
I20130723000248 MT Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 6204077993 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Washington School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacier Ear Nose and Throat Head and Neck Surgery PCGroup PAC ID 4880697432, 10 clinicians

Practice addresses (Care Compare)

160 Heritage Way
Suite 203
Kalispell, MT 59901-3127
Phone (406) 752-8330

Hospital & facility affiliations

  • Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051
  • Logan Health - Whitefish Hospital, Whitefish, MT, CCN 271336
  • Whitefish Care and Rehabilitation Nursing home, Whitefish, MT, CCN 275132

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN12195FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Ear Nose and Throat Head and Neck Surgery PC Otolaryngology CurrentSince Aug 1, 2013 Accepting new patients
Glacier Surgical Center, LLC Current Accepting new patients
Logan Health - Whitefish Past Accepting new patients

Locations

160 Heritage Way
Kalispell, MT 59901
Phone (406) 752-8330

160 Heritage Way
Ste 203
Kalispell, MT 59901
Phone (406) 752-8330

160 Heritage Way
Ste 201
Kalispell, MT 59901
Phone (406) 752-8330

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGIEDD

Organizations & group practices 5

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 9

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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1487818944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013102",
            "telephone_number": "406-752-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HERITAGE WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013102",
            "telephone_number": "406-752-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "KYLE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "TRN12195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "TRN12195",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487818944",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT STATE LICENSE",
            "identifier": "22321",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.