NPIMap

Individual provider Active NPI

Casey J. Kolendich, M.D.

  • Gastroenterology Physician
  • Missoula, MT
National Provider Identifier
1669511606
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
11522 Issued in MT
Practice address
1930 W Broadway St Ste a
Missoula, MT 59808-1960
Phone
(406) 541-6844
Fax
(406) 541-6843
NPI assigned
Feb 6, 2007
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 11522 MT Primary

Addresses

Primary practice location

1930 W Broadway St Ste a
Missoula, MT 59808-1960

Mailing address

1930 W Broadway St Ste a
Missoula, MT 59808-1960
Phone (406) 541-6844

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
I20070829000499 MT Practitioner - Gastroenterology 5496848905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Washington School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montana Gastroenterology, PLLCGroup PAC ID 7618396318, 23 clinicians

Practice addresses (Care Compare)

1930 W Broadway St
Suite a
Missoula, MT 59808-1960
Phone (406) 541-6844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy245
Upper gastrointestinal (GI) endoscopy for acid reflux199

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11522MTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of Anaconda Current Accepting new patients
Montana Gastroenterology, PLLC CurrentSince Oct 15, 2020 Accepting new patients
Montana Endoscopy Center, PLLC PastSince Jun 1, 2020 Accepting new patients

Locations

305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

1930 W Broadway St
Ste A
Missoula, MT 59808
Phone (406) 541-6844

500 W Broadway St
Ste A
Missoula, MT 59802
Phone (406) 284-5560

Organizations & group practices 3

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1669511606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 W BROADWAY ST STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081960",
            "telephone_number": "406-541-6844",
            "fax_number": "406-541-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W BROADWAY ST STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081960",
            "telephone_number": "406-541-6844",
            "fax_number": "406-541-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLENDICH",
        "first_name": "CASEY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "11522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.