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Individual provider Active NPI

Katelyn Myllymaki-Keller, PA-C

  • Physician Assistant
  • Great Falls, MT
National Provider Identifier
1912522483
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
88018 Issued in MT
Practice address
1101 26TH St S
Great Falls, MT 59405-5161
Phone
(406) 731-8888
Fax
(406) 731-8318
NPI assigned
Jun 10, 2020
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 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 88018 MT Primary

Addresses

Primary practice location

1101 26TH St S
Great Falls, MT 59405-5161

Mailing address

1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 731-8888

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmyllymakikeller19854@benefishs.direct-ci.com Benefis Hospitals Inc

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
I20200701002895 MT Practitioner - Physician Assistant 8224451638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 455-5000

PO Box
Suite 6010
Great Falls, MT 59406-6010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100Reported as group
Quality
62.64
Promoting interoperability
100
Improvement activities
40
Cost
80.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88018MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Benefis Hospitals, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1401 25th St S
Great Falls, MT 59405
Phone (406) 455-3650

25 14th Ave NW
Great Falls, MT 59404
Phone (406) 455-4777

2800 11th Ave S
Ste 12
Great Falls, MT 59405
Phone (406) 761-3556

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 6

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1912522483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLLYMAKI-KELLER",
        "first_name": "KATELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2024-04-08",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "88018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmyllymakikeller19854@benefishs.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "25 14th Ave NW",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594041954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.