Individual provider Active NPI

Matthew Risendal, D.O.

  • Urology Physician
  • Fishersville, VA
National Provider Identifier
1669904488
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0102207053 Issued in VA
Practice address
70 Medical Center Cir Ste 208
Fishersville, VA 22939-2273
Phone
(540) 332-5926
Fax
(540) 332-5930
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 132544 MT
Urology Physician 208800000X 0102207053 VA Primary

Addresses

Primary practice location

70 Medical Center Cir Ste 208
Fishersville, VA 22939-2273

Mailing address

PO Box 8310
Roanoke, VA 24014-0310
Phone (540) 345-3556

Other practice location 1

350 Heritage Way Ste 2300
Kalispell, MT 59901-3167
Phone (406) 890-7432

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220614002708 VA Practitioner - Urology 7618249707 Reassigns benefits to 1 organization
I20250731001987 MT Practitioner - Urology 7618249707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Nova Southeastern College of Osteo Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kalispell Regional Medical Center IncGroup PAC ID 5294644381, 422 clinicians

Practice addresses (Care Compare)

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-6725

320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 756-3526

350 Heritage Way
Kalispell, MT 59901-3167

Hospital & facility affiliations

  • Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051
  • Logan Health - Whitefish Hospital, Whitefish, MT, CCN 271336
  • Augusta Health Hospital, Fishersville, VA, CCN 490018
  • Cabinet Peaks Medical Center Hospital, Libby, MT, CCN 271320

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132544MTMDUrology Physician
0102207053VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center Inc CurrentSince Sep 8, 2025 Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Sep 8, 2025 Accepting new patients
Blue Ridge Urological, PC Urology CurrentSince Jul 1, 2022 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients

Locations

350 Heritage Way
Ste 2300
Kalispell, MT 59901
Phone (406) 752-8456

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

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

70 Medical Center Cir
Ste 208
Fishersville, VA 22939
Phone (540) 332-5926

2006 Health Campus Dr
Ste 201
Rockingham, VA 22801
Phone (540) 689-5900

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1669904488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140310",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR STE 208",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-332-5926",
            "fax_number": "540-332-5930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Heritage Way Ste 2300",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013167",
            "country_code": "US",
            "telephone_number": "406-890-7432",
            "fax_number": "406-890-7402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RISENDAL",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MT",
            "license": "132544",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0102207053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "350 Heritage Way Ste 2300",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.