NPIMap

Individual provider Active NPI

Dirk Gillette, PA

  • Physician Assistant
  • Kalispell, MT
National Provider Identifier
1508805920
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
282 Issued in MT
Practice address
1287 Burns Way
Kalispell, MT 59901-3109
Phone
(406) 752-8120
Fax
(406) 752-8134
NPI assigned
Jun 5, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 282 MT Primary

Addresses

Primary practice location

1287 Burns Way
Kalispell, MT 59901-3109

Mailing address

1287 Burns Way
Kalispell, MT 59901-3109
Phone (406) 752-8120

Other identifiers 3

IdentifierTypeStateIssuer
1508805920OtherMTBCBS
1053124OtherNCCPA
1508805920MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

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
I20040506001501 MT Practitioner - Physician Assistant 1052300944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1273 Burns Way
Kalispell, MT 59901-3109
Phone (406) 752-8300

160 Heritage Way
Kalispell, MT 59901-3127

350 Heritage Way
Kalispell, MT 59901-3167

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center, Inc CurrentSince Oct 1, 2010 Accepting new patients
Logan Health - Whitefish CurrentSince Mar 22, 2020 Accepting new patients
Family Health Care PC Current Accepting new patients
Logan Health - Whitefish Physician Assistant CurrentSince Mar 22, 2020 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Oct 1, 2010 Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients
Logan Health - Whitefish Past Accepting new patients

Locations

304 Osloski Rd
Eureka, MT 59917
Phone (406) 297-2438

1273 Burns Way
Kalispell, MT 59901
Phone (406) 752-5000

1287 Burns Way
Kalispell, MT 59901
Phone (406) 752-8120

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

3004 Hospital Way
Whitefish, MT 59937
Phone (406) 862-4763

711 E 13th St
Whitefish, MT 59937
Phone (406) 862-5575

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 9

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 7

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1508805920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 BURNS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013109",
            "telephone_number": "406-752-8120",
            "fax_number": "406-752-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 BURNS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013109",
            "telephone_number": "406-752-8120",
            "fax_number": "406-752-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "DIRK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1508805920",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1053124",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508805920",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "1287 Burns Way",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.