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KARL A GUTER MD
NPI 1437150331
Internal Medicine - Hematology & Oncology in Great Falls, MT

Active since August 02, 2005PECOS EnrolledAccepts Medicare Assignment
87.26/100
CMS Quality Rating
3000 15TH AVENUE SOUTH, GREAT FALLS, MT 59405(406) 454-2171(406) 771-3021 Get Directions Write a Review

NPPES record last updated: August 5, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Karl A Guter Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KARL A GUTER MD (NPI 1437150331) is an individual hematology & oncology provider in Great Falls, Montana, licensed in Montana (4182) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Benefis Hospitals Inc, and is a graduate of Saint Louis University School Of Medicine (1968).

NPPES Registry Identity

NPI1437150331
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameKARL A GUTERCredential: MD
Location Address3000 15TH AVENUE SOUTHGreat Falls, MT 59405
Mailing Address1400 29th St SGreat Falls, MT 59405-5353 · (406) 454-2171 · Fax (406) 771-3021
Phone(406) 454-2171
Fax(406) 771-3021
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 1968
Enumeration DateAugust 2, 2005
Last NPPES UpdateAugust 5, 2011
✔ NPI 1437150331 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in MT · 4182
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
3000 15TH AVENUE SOUTH, Great Falls, MT 59405
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Other Identifiers 3

Medicare PINM000001155MT
Medicaid0044083MT
Medicare UPIND07924

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Karl A Guter Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789724048
PECOS Enrollment IDI20091216000633
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
545 services146 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
379 services176 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
69 services60 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
28 services12 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
18 services18 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Benefis Hospitals Inc

Acute Care Hospitals · Great Falls, MT
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270012
Location1101 26th St SGreat Falls, MT 59405 · Cascade County
Emergency services Birthing friendly

Great Falls Clinic Hospital

Acute Care Hospitals · Great Falls, MT
5/5 CMS rating
OwnershipProprietary
CMS Certification Number270086
Location3010 15th Avenue SouthGreat Falls, MT 59405 · Cascade County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$172.26 typical visit price
range $56.81 – $172.26
Typical copayment $43.06 (range $14.20 – $43.06)
Most-billed visit code 99205
Established Patient
$100.16 typical visit price
range $18.24 – $140.32
Typical copayment $25.04 (range $4.56 – $35.08)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.97
Promoting Interoperability85.91
Improvement Activities40

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREGG D PIKE MD
Orthopaedic Surgery
3000 15TH AVENUE SOUTH
GREAT FALLS, MT 59405
Cascade County (406) 454-2171
JULIE JOAN BLISS MPT
Physical Therapist
3000 15TH AVENUE SOUTH
GREAT FALLS, MT 59405
Cascade County (406) 454-2171
JOHN T MOLLOY MD
Internal Medicine (Geriatric Medicine)
3000 15TH AVENUE SOUTH
GREAT FALLS, MT 59405
Cascade County (406) 454-2171

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Karl Guter's NPI number?

The NPI number for Karl Guter is 1437150331. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Karl Guter located?

Karl Guter practices at 3000 15th Avenue South, Great Falls, MT 59405. The listed phone number is (406) 454-2171.

What is Karl Guter's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Karl Guter enrolled in Medicare?

Yes. Karl Guter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Karl Guter accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and Providence Health Plan list Karl Guter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Karl Guter affiliated with any hospitals?

According to CMS data, Karl Guter is affiliated with Benefis Hospitals Inc and Great Falls Clinic Hospital.

When was this NPI record last updated?

The NPPES record for Karl Guter was last updated on August 5, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.