NPIMap

Individual provider Active NPI

Nena Panasuk, DO

  • Family Medicine Physician
  • Glendive, MT
National Provider Identifier
1770965972
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68248 Issued in MT
Practice address
107 Dilworth St
Glendive, MT 59330
Phone
(406) 345-8901
NPI assigned
Jun 24, 2015
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 68248 MT Primary

Addresses

Primary practice location

107 Dilworth St
Glendive, MT 59330

Mailing address

107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8901

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
I20180920003300 MT Practitioner - Family Practice 5193028421 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gabert Medical Services IncGroup PAC ID 2668385402, 23 clinicians
Glendive Medical Center IncGroup PAC ID 7214846823, shared by 6 NPIs, 16 clinicians

Practice addresses (Care Compare)

107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8901

202 Prospect Dr
Glendive, MT 59330-1943
Phone (406) 345-3306

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68248MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glendive Medical Center, Inc CurrentSince Oct 1, 2020 Accepting new patients
Glendive Medical Center, Inc CurrentSince Oct 1, 2020 Accepting new patients
Glendive Medical Center, Inc CurrentSince Oct 1, 2020 Accepting new patients
Gabert Medical Services, Inc CurrentSince Sep 6, 2018 Accepting new patients
Glendive Medical Center, Inc Current Accepting new patients
Glendive Medical Center, Inc Past Accepting new patients

Locations

107 Dilworth St
Glendive, MT 59330
Phone (406) 345-8900

202 Prospect Dr
Glendive, MT 59330
Phone (406) 345-3306

Interoperability endpoints

  • Direct secure messaging: npanasuk@gmc.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1770965972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "59330",
            "telephone_number": "406-345-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANASUK",
        "first_name": "NENA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "68248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendive, MT

Sources for this page

Verify at the official NPI Registry.