NPIMap

Individual provider Active NPI

Kimberly Dawn Studiner, PA

  • Physician Assistant
  • Lame Deer, MT
National Provider Identifier
1609058411
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
517 Issued in MT
Practice address
420 Cheyenne Ave
Lame Deer, MT 59043
Phone
(406) 477-4554
Fax
(406) 477-4554
NPI assigned
Dec 4, 2007
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 517 MT Primary

Addresses

Primary practice location

420 Cheyenne Ave
Lame Deer, MT 59043

Mailing address

PO Box 70
420 Cheyenne Ave
Lame Deer, MT 59043
Phone (406) 477-4554

Other identifiers 2

IdentifierTypeStateIssuer
517OtherMTSTATE LICENSE
9901939MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080103000136 MT Practitioner - Physician Assistant 0941119606 Reassigns benefits to 1 organization
I20090930000328 TX Practitioner - Physician Assistant 0941119606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Cheyenne Ave
Lame Deer, MT 59043-0000
Phone (406) 477-4451

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
517MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
U S Health Dept of Health & Human Services CurrentSince Jul 28, 2009 Accepting new patients
County of Rosebud Past Accepting new patients
Ashland Community Health Center PastSince Apr 30, 2003 Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1609058411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "address_2": "420 CHEYENNE AVE",
            "city": "LAME DEER",
            "state": "MT",
            "postal_code": "59043",
            "telephone_number": "406-477-4554",
            "fax_number": "406-477-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CHEYENNE AVE",
            "city": "LAME DEER",
            "state": "MT",
            "postal_code": "59043",
            "telephone_number": "406-477-4554",
            "fax_number": "406-477-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDINER",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "517",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9901939",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lame Deer, MT

Sources for this page

Verify at the official NPI Registry.