Chronic Disease Management, LLC
NPI 1154032472ActiveOrganization· Physician Assistant· Clancy, MT
Physician Assistant in Clancy, Montana, registered in NPPES in December 2022. The authorized official on file is Mark Donald Kishbaugh, PA-C, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1154032472 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 7, 2022 |
| Last updated in NPPES | Jul 27, 2023 |
| Certified by provider | Jul 27, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
| Clinic/Center, Health Services | 261QH0100X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MT) |
|---|
Other Physician Assistant providers in Clancy
- 1467410803