NPIMap

Individual provider Active NPI

Karyn Regina Sande, PA-C

  • Physician Assistant
  • Missoula, MT
National Provider Identifier
1841613932
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MED-PAC-LIC-35994 Issued in MT
Practice address
500 W Broadway St Ste 320
Missoula, MT 59802-4031
Phone
(406) 329-5615
Fax
(406) 329-2791
NPI assigned
Jan 27, 2014
Last updated
Sep 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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-35994 MT Primary

Addresses

Primary practice location

500 W Broadway St Ste 320
Missoula, MT 59802-4031

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (866) 747-2455

Other names 1

  • Karyn Regina Zwickey Former name

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
I20150207000448 MT Practitioner - Physician Assistant 3173848454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians
Providence St Joseph Medical CenterGroup PAC ID 0446230247, shared by 5 NPIs, 52 clinicians

Practice addresses (Care Compare)

3017 Paxson St
Missoula, MT 59801-8325
Phone (406) 519-3422

500 W Broadway St
Missoula, MT 59802-4003

500 W Broadway St
Missoula, MT 59802-4096

500 W Broadway St
Suite 320
Missoula, MT 59802-4031
Phone (406) 329-5615

500 W Broadway St 3Rd FL
Missoula, MT 59802-4096

6 13TH Ave E
Polson, MT 59860-5315
Phone (406) 883-5377

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt CurrentSince Aug 8, 2016 Accepting new patients
Providence Health & Services Mt CurrentSince Aug 8, 2016 Accepting new patients

Locations

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

Interoperability endpoints

  • Direct secure messaging: kzwickey630184@wm.providencedirect.org

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 11

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": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1841613932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST STE 320",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024031",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDE",
        "first_name": "KARYN",
        "middle_name": "REGINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-35994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARYN",
            "last_name": "ZWICKEY",
            "middle_name": "REGINA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.