Individual provider Active NPI

Gary J Willstein, MD

  • Orthopaedic Surgery Physician
  • Missoula, MT
National Provider Identifier
1932154671
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
9552 Issued in MT
Practice address
2360 Mullan Rd
Ste C
Missoula, MT 59808-1811
Phone
(406) 721-4436
Fax
(406) 721-3907
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 9552 MT Primary

Addresses

Primary practice location

2360 Mullan Rd
Ste C
Missoula, MT 59808-1811

Mailing address

2360 Mullan Rd
Ste C
Missoula, MT 59808-1811
Phone (406) 721-4436

Other identifiers 1

IdentifierTypeStateIssuer
0028002MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
29.27 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
97.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9552MTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Montana Clinic PC Current Accepting new patients
Western Montana Clinic PC Current Accepting new patients
Providence Surgery Center PastSince Feb 27, 2007 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1932154671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MULLAN RD",
            "address_2": "STE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081811",
            "telephone_number": "406-721-4436",
            "fax_number": "406-721-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 MULLAN RD",
            "address_2": "STE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081811",
            "telephone_number": "406-721-4436",
            "fax_number": "406-721-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSTEIN",
        "first_name": "GARY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MT",
            "license": "9552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028002",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.