Kelly Polus, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

397 Issued in MT

Practice address

610 N California St
Missoula, MT 59802-3950

Phone

(406) 721-1646

Fax

(406) 543-9890

NPI assigned

Sep 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Mountain Clinic, Inc.Group PAC ID 4688600984, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014
• Community Medical Center Hospital, Missoula, MT, CCN 270023

Merit-based Incentive Payment System (MIPS)

Final score

98.34 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

78.56

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kelly.polus.1@15229.direct.athenahealth.com

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.

• Blue Mountain Clinic, Inc.

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1407987548
  Medicare reassignment Care Compare group

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

• Providence Health & Services Mt

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1689770919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N CALIFORNIA ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023950",
            "telephone_number": "406-721-1646",
            "fax_number": "406-543-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N CALIFORNIA ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023950",
            "telephone_number": "406-721-1646",
            "fax_number": "406-543-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLUS",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4304604",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.polus.1@15229.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "610 N California St",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598023950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Anne Polanchek, EDD, LCSW
• Honani Polequaptewa, PT, MPT, CEEAA, LMT
• Deborah Lynne Polk, REGISTERED PHARMACI
• Trenton Pollard, LMT
• Kimberlee Ann Pollock, L.M.T
• Pomalo PLLC
• Melissa Pomaville, DPT
• Pondering Pines Counseling Services PLLC
• Sarah M Poole, LCSW
• George Pope, DO

• Physician Assistant in Missoula, MT
• Providers in Missoula, MT by specialty
• Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.