Kelly Ryan Coyle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MED-PAC-LIC-90799 Issued in MT

Practice address

1905 W College St
Bozeman, MT 59718-4061

Phone

(406) 587-4432

Fax

(406) 587-7015

NPI assigned

Nov 11, 2020

Last updated

Jul 12, 2022By the provider in NPPES

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

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bozeman Health Deaconess Hospital Hospital, Bozeman, MT, CCN 270057

Merit-based Incentive Payment System (MIPS)

Final score

90.88 of 100Reported as group

Quality

93.51

Improvement activities

40

Cost

78.25

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcoyle@directaddress.net

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Missoula, MT
  • NPI 1922647395
  Medicare reassignment Care Compare group NPD
• Montana Skin Cancer and Dermatology Center, P.C.

  dba SkinCare MT

  • Dermatology Physician
  • Bozeman, MT
  • NPI 1487082087
  Medicare reassignment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  dba SkinCare MT, A Forefront Dermatology Practice

  • Dermatology Physician
  • Bozeman, MT
  • NPI 1710869730
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

• Bozeman Health Deaconess Hospital

  • General Acute Care Hospital
  • Bozeman, MT
  • NPI 1104295864
  Care Compare affiliation

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1851993182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 W COLLEGE ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184061",
            "telephone_number": "406-587-4432",
            "fax_number": "406-587-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 W COLLEGE ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184061",
            "telephone_number": "406-587-4432",
            "fax_number": "406-587-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "KELLY",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-90799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcoyle@directaddress.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1905 W College St",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597184061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Costco Wholesale Corporation (Costco Optical #96)
• Costco Wholesale Corporation (Costco Pharmacy # 96)
• Stephen Michael Cottle, PA-C
• Counseling With Claire (Clarity Counseling)
• Jerad William Cox
• Peter Coyle
• Ashley Cozzens, RPH
• Claire Anne Caitlin Crane, MD
• Erin M Cravens, MSW, LCSW
• Klazina Crawford

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.