Kenny Joe Wallen, DNP is a medicare enrolled "Nurse Anesthetist, Certified Registered" physician in Dillon, Montana. His current practice location is
600 State Hwy 91 S, Dillon, Montana. You can reach out to his office (for appointments etc.) via phone at
(406) 683-3000.
Kenny Joe Wallen is licensed to practice in Montana (license number 132231) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1649628553.
Physician's Profile
| Full Name | Kenny Joe Wallen |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Anesthetist, Certified Registered |
|---|
| Location | 600 State Hwy 91 S, Dillon, Montana |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1649628553
- Provider Enumeration Date: 06/01/2016
- Last Update Date: 12/08/2025
Medicare PECOS Information:
- PECOS PAC ID: 4183916182
- Enrollment ID: I20171228002910
Medical Identifiers
Medical identifiers for Kenny Joe Wallen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1649628553 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 132231 (Montana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 132231 (Montana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenny Joe Wallen allows following entities to bill medicare on his behalf.
| Entity Name | Medstream Anesthesia Pllc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1649616160 PECOS PAC ID: 7416198049 Enrollment ID: O20130724000770 |
|---|
| Entity Name | Clinical Colleagues Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1992725766 PECOS PAC ID: 8729011333 Enrollment ID: O20150529001085 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenny Joe Wallen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Kenny Joe Wallen, DNP 386 White Horse Loop, Bozeman, MT 59718-1223 Ph: (918) 906-1697 | Kenny Joe Wallen, DNP 600 State Hwy 91 S, Dillon, MT 59725-7379 Ph: (406) 683-3000 |
Reviews and Comments