Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kelly Polus, PAC

Individual provider Physician Assistant · NPI 1689770919

MS. Kelly Polus, PAC is a Physician Assistant in Missoula, Montana. Qualified in 2004, 22 years ago. Practices with Blue Mountain Clinic, Inc, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Montana.

Years since qualifying
22
Licensed in
MT
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

610 N California St
Missoula, MT 59802-3950
Phone: (406) 721-1646
Fax: (406) 543-9890
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 397 (MT)

Record details

NPI number1689770919
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedSeptember 15, 2006
Last updated in NPPESOctober 7, 2021
Certification dateOctober 7, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Blue Mountain Clinic, Inc. — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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