MS. KELLY POLUS PAC
NPI 1689770919
Physician Assistant in Missoula, MT

Q: What is Kelly Polus's NPI number?

The NPI number for Kelly Polus is 1689770919. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Q: What is Kelly Polus's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Polus was last updated on October 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since September 15, 2006PECOS EnrolledAccepts Medicare Assignment

93.88/100

CMS Quality Rating

610 N CALIFORNIA ST, MISSOULA, MT 59802(406) 721-1646(406) 543-9890 Get Directions Write a Review

NPPES record last updated: October 7, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Ms. Kelly Polus Pac NPPES

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

MS. KELLY POLUS PAC (NPI 1689770919) is an individual physician assistant in Missoula, Montana, licensed in Montana (397) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with St. Patrick Hospital, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1689770919

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. KELLY POLUSCredential: PAC

Location Address610 N CALIFORNIA STMissoula, MT 59802-3950

Mailing Address610 N California StMissoula, MT 59802-3950 · (406) 721-1646 · Fax (406) 543-9890

Phone(406) 721-1646

Fax(406) 543-9890

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateSeptember 15, 2006

Last NPPES UpdateOctober 7, 2021

NPPES CertifiedOctober 7, 2021

✔ NPI 1689770919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MT · 397

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

610 N CALIFORNIA ST, Missoula, MT 59802

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Other Identifiers 1

Medicaid4304604MT

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

Ms. Kelly Polus Pac 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 ID5698701993

PECOS Enrollment IDI20050708000474

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 7

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.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

71 services50 patients

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.

45 services28 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

30 services30 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.

28 services21 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

18 services18 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

13 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St. Patrick Hospital

Acute Care Hospitals · Missoula, MT

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number270014

Location500 W BroadwayMissoula, MT 59806 · Missoula County

Emergency services Birthing friendly

Community Medical Center

Acute Care Hospitals · Missoula, MT

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number270023

Location2827 Fort Missoula RdMissoula, MT 59804 · Missoula County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59802 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

$87.97 typical visit price

range $56.81 – $172.26

Typical copayment $21.99 (range $14.20 – $43.06)

Most-billed visit code 99203

Established Patient

$70.82 typical visit price

range $18.24 – $140.32

Typical copayment $17.70 (range $4.56 – $35.08)

Most-billed visit code 99213

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.

93.88/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

90.36

Promoting Interoperability

100

Improvement Activities

Cost

72.75

Reported Quality Measures

Advance Care Plan

68%73 patients3/55-star benchmark: 100%

Breast Cancer Screening

72%148 patients4/55-star benchmark: 93%

Cervical Cancer Screening

72%544 patients3/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

39%285 patients2/55-star benchmark: 87%

Colorectal Cancer Screening

66%248 patients4/55-star benchmark: 88%

Diabetes: Eye Exam

34%35 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

26%35 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

94%1,395 patients4/55-star benchmark: 100%

e-Prescribing

98%1,807 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

47%503 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

38%1,127 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 53% · 610 patients

Patients screened: 61% · 610 patients

25%65 patients2/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

87%520 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 10

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

DR. ERIC A. RAVITZ D.O.

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