Individual provider Active NPI

Gareth Lance Gardiner, MD

  • Anesthesiology Physician
  • Missoula, MT
National Provider Identifier
1932638533
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MED-PHYS-LIC-97106 Issued in MT
Practice address
2825 Stockyard Rd Ste I-200
Missoula, MT 59808-1548
Phone
(406) 728-8420
Fax
(406) 541-8430
NPI assigned
Jun 7, 2017
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R-10965 IA
Anesthesiology Physician 207L00000X MED-PHYS-LIC-97106 MT Primary

Addresses

Primary practice location

2825 Stockyard Rd Ste I-200
Missoula, MT 59808-1548

Mailing address

200 Hawkins Dr Dept of
Iowa City, IA 52242-1009

Other practice location 1

200 Hawkins Dr Dept Of
Iowa City, IA 52242-1009
Phone (319) 356-1338

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621001772 MT Practitioner - Anesthesiology 1759651375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Utah School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missoula Anesthesiology PCGroup PAC ID 5597669960, 45 clinicians

Practice addresses (Care Compare)

500 W Broadway
St Patrick Hospital
Missoula, MT 59802-4008
Phone (406) 543-7271

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-10965IAMDAnesthesiology Physician
MED-PHYS-LIC-97106MTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missoula Anesthesiology, P.C. Anesthesiology CurrentSince Aug 14, 2021 Accepting new patients
Ma Critical Care Services, PC Past Accepting new patients

Locations

2360 Mullan Rd
Missoula, MT 59808
Phone (406) 541-4263

2825 Stockyard Rd
Ste I-200
Missoula, MT 59808
Phone (406) 728-4100

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2833 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 542-6559

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

902 N Orange St
Missoula, MT 59802
Phone (406) 327-3300

Organizations & group practices 2

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 5

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1932638533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR DEPT OF",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE I-200",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081548",
            "telephone_number": "406-728-8420",
            "fax_number": "406-541-8430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr Dept Of",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-1338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "GARETH",
        "middle_name": "LANCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "R-10965",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-97106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.