Individual provider Active NPI

Katrin Johanna Kahl, PA-C

  • Physician Assistant
  • Missoula, MT
National Provider Identifier
1730664723
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MED-PAC-LIC-137293 Issued in MT
Practice address
610 N California St
Missoula, MT 59802-3950
Phone
(406) 721-1646
Fax
(406) 543-9890
NPI assigned
Sep 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 MED-PAC-LIC-137293 MT Primary

Addresses

Primary practice location

610 N California St
Missoula, MT 59802-3950

Mailing address

610 N California St
Missoula, MT 59802-3950
Phone (406) 721-1646

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241002003127 MT Practitioner - Physician Assistant 0547681579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Mountain Clinic, Inc.Group PAC ID 4688600984, 4 clinicians

Practice addresses (Care Compare)

610 N California St
Missoula, MT 59802-3950
Phone (406) 721-1646

Hospital & facility affiliations

  • Community Medical Center Hospital, Missoula, MT, CCN 270023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7875AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group (Coats) LTD. PastSince Feb 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: katrin.kahl.1@15229.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1730664723",
    "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": "KAHL",
        "first_name": "KATRIN",
        "middle_name": "JOHANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-137293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.