Advanced Practice Provider Gastroenterology

Local GI market

10 gastroenterologists

within 30 miles. That is 16.8 per 100,000 adults aged 45-74, 24% more than the US average (13.6).

30% of them finished medical school 30 or more years ago (US: 36%).

Source: CMS Doctors and Clinicians file; Census ACS 2019-2023.

Procedure mix nearby

66% colonoscopy

Medicare fee-for-service procedures billed within 30 miles in 2024: 1,664 colonoscopies, 738 EGDs, 115 ERCPs, 0 EUS.

ERCP volume is heavy and no EUS for the population, compared with the US (adjusted for Medicare Advantage share). 100% done in a hospital or surgery center; 76% by gastroenterologists.

63.8% of adults 45-75 in this county are up to date on colorectal screening, about the same as the state (63.8%).

38% of Medicare patients here are in Medicare Advantage (state: 30%). Medicare procedure counts above cover only the other 62%.

Source: CMS Medicare Physician and Other Practitioners by provider and service, 2024 (fee-for-service only; services for fewer than 11 patients hidden). CMS MA penetration; CDC PLACES 2025 (2022 survey).

Cost of living

Prices in Montana are 5.4% below the US average.

Montana state income tax on $450k: about $25k (5.5%), single filer, before deductions. Local taxes not included. ($450k is a reference salary; this ad states none.)

Source: BEA regional price parities, 2024. State level; big metros cost more. Tax: Tax Foundation 2026 state brackets.

Hospitals and surgery centers

1 hospital, 5 surgery centers

within 30 miles. 1 of the hospitals run an emergency department; 1 of 1 rated hold 4 or 5 CMS stars.

Nearest: Billings Clinic Hospital (16 mi, 4 stars).

None of the surgery centers reported enough Medicare colonoscopies to publish. More endoscopy centers usually means more ASC ownership and partnership options.

Source: CMS Care Compare, Hospital General Information and ASC Quality Reporting (ASC-12 colonoscopy cases, Medicare fee-for-service). Located by ZIP code.

State rules for your contract

Noncompete: Void for physicians

Noncompetes and patient non-solicits for physicians are void. Mont. Code § 28-2-724, from 2026-01-01. Usually covers only contracts signed after that date.

Interstate Medical Licensure Compact: member (faster multi-state licensing).

State law summary, not legal advice. Have a contract lawyer read your agreement. Source; IMLC states; all states.

Employer

Nonprofit health system, 501(c)(3)

The employer is a 501(c)(3) nonprofit. W-2 jobs with it usually count toward Public Service Loan Forgiveness (PSLF). Confirm which entity pays you.

Source

Visas (H-1B / J-1)

This employer filed 3 H-1B wage filings for attending GI physicians (2025), at $550k-$600k (median $600k).

Parts of this county are federal primary care shortage areas (HPSAs). Check the exact practice address. Conrad 30 J-1 waiver jobs usually must be in a shortage area; each state sets its own rules. State J-1 waiver contacts (3RNET).

Source: US Dept. of Labor LCA disclosure data (certified H-1B, FY2024-FY2026); HRSA HPSA data. All GI H-1B employers