| David L Nieman, PA-C | |
|
107 Dilworth St, Glendive, MT 59330-2053 | |
| (406) 345-8935 | |
| (406) 345-8908 |
| Full Name | David L Nieman |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 29 Years |
| Location | 107 Dilworth St, Glendive, Montana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760568869 | NPI | - | NPPES |
| 0207865 | Other | WA | L&I |
| 8500225 | Medicaid | WA | |
| 9947NI | Other | WA | REGENCE RIDER |
| 8941215 | Other | WA | L&I CVC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA10004978 (Washington) | Secondary |
| 363AM0700X | Physician Assistant - Medical | (Montana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Logan Health Home Care | Kalispell, MT | Home health agency |
| Enhabit Home Health | Helena, MT | Home health agency |
| Logan Health Medical Center | Kalispell, MT | Hospital |
| Logan Health - Whitefish | Whitefish, MT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kalispell Regional Medical Center Inc | 5294644381 | 422 |
| Entity Name | Glendive Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033129622 PECOS PAC ID: 7214846823 Enrollment ID: O20031103000338 |
| Entity Name | Kalispell Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417945627 PECOS PAC ID: 5294644381 Enrollment ID: O20031122000142 |
| Mailing Address | Practice Location Address |
|---|---|
| David L Nieman, PA-C 107 Dilworth St, Glendive, MT 59330-2053 Ph: (406) 345-8935 | David L Nieman, PA-C 107 Dilworth St, Glendive, MT 59330-2053 Ph: (406) 345-8935 |
Samuel C Mintz, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
Rodney Hickman, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
Jack W. Haas, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
Ms. Audrey J. Kerr, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3314 Fax: 406-345-3324 |
Sandra Janzen, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |
Carleen Gaub, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 Dilworth St, Glendive, MT 59330 Phone: 406-345-8900 Fax: 406-345-8908 |
Teresea Olson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 202 Prospect Dr, Glendive, MT 59330 Phone: 406-345-3306 Fax: 406-345-3358 |