Individual provider Active NPI

Kylie Marie Edinger, MD

  • Plastic Surgery Physician
  • Bozeman, MT
National Provider Identifier
1659877207
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MED-PHYS-LIC-156327 Issued in MT
Practice address
1994 Stadium Dr
Bozeman, MT 59715-0655
Phone
(406) 587-0767
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MED-PHYS-LIC-156327 MT Primary

Addresses

Primary practice location

1994 Stadium Dr
Bozeman, MT 59715-0655

Mailing address

1994 Stadium Dr
Bozeman, MT 59715-0655
Phone (064) 587-0767

Other practice location 1

915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 414-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180720000729 WI Order and Referring Only - Plastic and Reconstructive SurgeryPractitioner - Plastic and Reconstructive Surgery 9032466149

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-156327MTMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgway Plastic Surgery, PLLC Plastic Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1659877207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1994 STADIUM DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597150655",
            "telephone_number": "064-587-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1994 STADIUM DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597150655",
            "telephone_number": "406-587-0767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Highland Blvd",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597156902",
            "country_code": "US",
            "telephone_number": "406-414-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDINGER",
        "first_name": "KYLIE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MT",
            "license": "MED-PHYS-LIC-156327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.