MS. DAWN GORMELY FNPC
NPI 1659359792
Nurse Practitioner in Helena, MT
NPI Status: Active since January 09, 2006
Contact Information
1930 9TH AVENUE
HELENA, MT
ZIP 59601
Phone: (406) 457-0000
Fax: (406) 457-8992
- Individual
- Female
- Nurse Practitioner
- Accepts Insurance
- PECOS Enrolled
About DAWN GORMELY
This page provides the complete NPI Profile along with additional information for Dawn Gormely, a provider established in Helena, Montana with a medical specialization in Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1659359792 assigned on January 2006. The practitioner's primary taxonomy code is 363L00000X with license number MTRN016908 (MT). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1659359792
- Provider Name
- MS. DAWN GORMELY FNPC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1930 9TH AVENUE HELENA, MT 59601
- Location Phone
- (406) 457-0000
- Location Fax
- (406) 457-8992
- Mailing Address
- 1930 9TH AVE HELENA, MT 59601
- Mailing Phone
- (406) 457-0000
- Mailing Fax
- (406) 457-8992
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-09-2006
- Last Update Date
- 02-25-2020
- Code Navigator
A nurse practitioner (NP) like Dawn Gormely is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- MTRN016908
- License State
- MT
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 50006414 | OTHER (01) | MT | RAILROAD MEDICARE |
| 439036 | MEDICAID (05) | MT | |
| 37086 | OTHER (01) | MT | BCBS |
Medicare Participation & PECOS Enrollment Status
Dawn Gormely is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
6 DME suppliers used 24 Medicare Claims 43 Services Paid
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
3 DME suppliers used 22 Medicare Claims 22 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
4 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
4 DME suppliers used 15 Medicare Claims 34 Services Paid
DME-Other DME (DE001N)
Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)
2 DME suppliers used 11 Medicare Claims 63 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
4 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
4 DME suppliers used 26 Medicare Claims 131 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
3 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
3 DME suppliers used 76 Medicare Claims 84 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable oxygen contents, gaseous, 1 month's supply = 1 unit (HCPCS:E0443)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
5 DME suppliers used 117 Medicare Claims 122 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
2 DME suppliers used 14 Medicare Claims 14 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Creatinine level to test for kidney function or muscle injury
Hemoglobin a1c level
Urine microalbumin (protein) analysis
A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.
This service was performed 16 times for 16 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 59 times for 38 patientsUrine microalbumin analysis is a test that measures the amount of a protein called albumin in your urine. This protein is usually present in very small amounts, but higher levels can indicate kidney issues. The test is non-invasive and involves a simple urine sample.
This service was performed 16 times for 16 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 59601 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $87.97
- Minimum New Patient Price $56.81
- Maximum New Patient Price $172.26
- Average New Patient Copayment $21.99
- Minimum New Patient Copayment $14.2
- Maximum New Patient Copayment $43.06
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.16
- Minimum Established Patient Price $18.24
- Maximum Established Patient Price $140.32
- Average Established Patient Copayment $25.04
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.08
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1659359792, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 78. The final step is to find the difference between that total and the next multiple of ten (80 - 78 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 78 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
HELENA, MT 59601
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659359792, enumerated as an "individual" on January 09, 2006.
The provider is located at 1930 9TH AVENUE HELENA, MT 59601 and the phone number is (406) 457-0000.
Nurse Practitioner with taxonomy code 363L00000X.
The provider might be accepting Accepts: Providence Health Plan, Railroad Medicare,. Please consult your insurance carrier or call the provider to verify.
