Carlye Bolstad, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MED-PAC-LIC-68538 Issued in MT

Practice address

3703 Harrison Ave Ste B
Butte, MT 59701-6897

Phone

(406) 565-5730

Fax

(405) 565-5734

NPI assigned

Dec 21, 2010

Last updated

Aug 29, 2019By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Premise Health of Montana Medical PC

  dba Butte Montana Health Center

  • Multi-Specialty Clinic/Center
  • Butte, MT
  • NPI 1720679137
  NPD
• Premise Health of Montana Medical PC

  dba Missoula Montana Health Center

  • Multi-Specialty Clinic/Center
  • Missoula, MT
  • NPI 1629669031
  NPD (past)

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1528362159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 HARRISON AVE STE B",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597016897",
            "telephone_number": "406-565-5730",
            "fax_number": "406-565-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 HARRISON AVE STE B",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597016897",
            "telephone_number": "406-565-5730",
            "fax_number": "405-565-5734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Saddle Dr",
            "address_purpose": "LOCATION",
            "city": "Helena",
            "state": "MT",
            "postal_code": "596015632",
            "country_code": "US",
            "telephone_number": "406-502-1355",
            "fax_number": "406-206-0304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLSTAD",
        "first_name": "CARLYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA159424",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "MED-PAC-LIC-68538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Mountain Counseling
• Bodine Medical LLC
• Jonathan A Bodine, D.O.
• Kerry Bohlken, APRN, FNP-C
• Timothy Bolewicz, OTR
• Alyssa Bolton, MS CCC-SLP
• Loretta Lynn Bolyard, PH.D.
• Kirstin Ranae Borge, OTR
• Jennifer Bosley, LCPC
• Shelby Box, ATC

• Medical Physician Assistant in Butte, MT
• Providers in Butte, MT by specialty
• Medical Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.