Five Valley Urology

What Five Valley Urology does

Five Valleys Urology is an independent, physician-led urology practice headquartered in Missoula, Montana, formally founded in 2002 (with clinical roots traceable to Dr. David Guth's 1977 solo practice) and serving patients across Western Montana. The practice operates a single-market, multi-channel delivery model combining in-office consultations, an accredited in-house laboratory (PSA, testosterone, urinalysis, PCR), telehealth visits, and surgical procedures delivered via surgical privileges at five area hospitals and the Big Sky Surgery Center. Its clinical scope spans the full urological spectrum, including prostate cancer (with the Advanced Prostate Care Clinic, Provenge immunotherapy, Hydrogel spacers, robotic prostatectomy), BPH (UroLift Center of Excellence, HoLEP, Aquablation), urinary incontinence (Axonics, NURO, in-bladder Botox), men's sexual health, stone disease, vasectomy, urodynamic diagnostics, and women's pelvic health (MonaLisa Touch). Multiple service lines are Montana-firsts (robotic-assisted laparoscopic urologic procedures, Provenge, MonaLisa Touch), and the practice holds exclusive Montana capability for HoLEP.

The business model is fee-for-service clinical revenue billed through Medicare, Medicaid, VA Connected Care, and major commercial insurers (BlueCross BlueShield of Montana, Allegiance, PacificSource, GEHA), with self-pay cost estimates upon request. Patient acquisition is sales-led (physician referral) complemented by community reputation, self-referral, and telehealth-enabled reach into a geographically dispersed rural catchment where travel costs materially constrain access. The practice is led by four board-certified urologists (Westenfelder, Wicher, Redshaw, Reynolds) and three advanced practice providers (O'Neill, Muskett, Dealy), supported by registered nurses, medical assistants, and certified business professionals; non-clinical leadership is provided by CEO John O'Connor (since 2002-2003) and Director of Operations Melanie Scott.

The practice has remained independent, with no disclosed parent company, private equity sponsor, or institutional investment; growth has been organic through sequential provider recruitment (2006, 2011, 2019, 2022, 2024, 2025) and incremental technology adoption rather than M&A or external capital. Notable signals include the 2020 Medical Economics Better Performers Badge, the nurse-navigator-led Advanced Prostate Care Clinic, and an expanding telehealth and women's pelvic-health offering, all consistent with measured, capacity-led expansion within the Western Montana catchment.

Name

Five Valley Urology

Legal name

Five Valleys Urology

Website

https://fivevalleysurology.com

Company type

Private

Founded year

2002

Operating status

Operating

Headcount range

11–50 employees

Short description

Five Valleys Urology is an independent, physician-led urology practice in Missoula, Montana providing diagnostic, surgical, and telehealth urological care to patients across Western Montana, with first-in-Montana capabilities in robotic prostatectomy, Provenge immunotherapy, MonaLisa Touch, and HoLEP.

Ownership category

akta.pro rank

Product category

Urology Healthcare Services

NAICS

Ambulatory Health Care Services (621)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011)

akta.pro primary industry

General Urology (HLAKAOAA)

akta.pro secondary industries

Urolithiasis / Kidney Stone Centers (HLAKAOAG), Endourology & Minimally Invasive Urologic Surgery (HLAKAOAF), Urology Telemedicine Platforms (HLALAGAN), Urogynecology & Pelvic Reconstructive Surgery (Female Pelvic Medicine) (HLAKAJAE), Toileting & Incontinence Care (HSABABAC)

Keywords

• Urology care
• Surgical procedures
• Prostate treatment
• Men's health
• Diagnostic services

Headquarters

HQ city

Missoula

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales

Revenue model

1. Clinical Services Revenue: Fee-for-service revenue from patient consultations, diagnostic services, and surgical procedures for urological conditions. Services include in-office procedures, hospital-based surgeries, and telehealth visits. Insurance billing through Medicare, Medicaid, and major commercial insurers.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

Five Valleys Urology is an independent, physician-led urology practice in Missoula, Montana, providing diagnostic, medical, and surgical care for urological conditions in adult and pediatric patients. The practice delivers in-office consultations, advanced minimally invasive and robotic surgical procedures, specialized prostate cancer care, men's sexual health services, and telehealth visits across Western Montana.

Product overview

Five Valleys Urology operates as a comprehensive urological care practice offering a unified suite of medical and surgical services rather than a platform-plus-modules architecture. The practice provides diagnostic care and surgical treatment for both male and female patients through integrated service lines including: in-office laboratory testing (PSA, testosterone, urinalysis, PCR), advanced surgical procedures (da Vinci robotic prostatectomy, HoLEP laser surgery, Aquablation), specialized treatment programs (Men's Sexual Health, Advanced Prostate Care Clinic with nurse navigation), medical device therapies (MonaLisa Touch laser, UroLift System, Axonics sacral neuromodulation, NURO tibial neuromodulation, Hydrogel spacers), overactive bladder treatments (Botox injections), and telehealth/virtual care delivery. The practice also maintains a HIPAA-secure patient portal powered by ModMed for health information access, prescription refills, and virtual visits. All services are delivered through their physician-led team of board-certified urologists and advanced practice providers at their Missoula, Montana facility.

Differentiator

Problem solved

Functional benefit

Products and services

• da Vinci Robotic Prostatectomy

Quantifiable outcome

• 90% effective in creating erection with Timm Medical Vacuum Therapy Systems
• +2 more outcomes

Named customers1 record

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature9 records

Partnerships

Four partnerships are on record, tiered core and minor.

• Providence Saint Patrick HospitalcoreOthersHospital-based surgical procedures and physician privileges. Five Valleys Urology physicians assist in leadership and development of robotic surgery programs at this facility.
• Community Medical CentercoreOthersHospital-based surgical procedures and physician privileges. Five Valleys Urology physicians hold surgical privileges and participate in leadership activities.
• Big Sky Surgery CentercoreOthersAmbulatory surgery center where Five Valleys Urology physicians perform outpatient surgical procedures.
• Monida Healthcare NetworkminorStrategic or Co-development PartnerJohn O'Connor serves as Core Group member of Monida Healthcare Network, a healthcare network organization.

Scale indicators4 records

Recent moves9 records

Expansion highlights6 records

Regional players

• Cascade Urology / WWMG Urology: Multi-specialty medical group serving Western Washington and the Pacific Northwest. Comparable in serving rural/semi-urban markets with urology as one specialty line; offers analogous advanced treatment offerings across a similar geographic profile.
• Spokane Urology / Providence Medical Group: Urology group serving the Spokane and Inland Northwest region with advanced urologic care. Comparable in that it serves a similar rural/semi-urban catchment, though it operates under the Providence health system banner rather than as an independent group.

Emerging players

• Urology America: Platform consolidating independent urology practices across the U.S. Highly relevant as a potential acquirer or partner for an independent group like Five Valleys considering scale, succession, or capital needs.

Direct peers

• Michigan Institute of Urology: Large independent urology group providing full-spectrum urologic care including robotic, laser, and BPH procedures. Comparable by model and breadth of services though larger in scale than Five Valleys.
• Advanced Urology (Colorado): Large independent multi-physician urology group in the Mountain West/Rocky Mountain region. Comparable offering across robotic surgery, BPH treatments (UroLift, HoLEP, Aquablation), prostate cancer care, and men's health, with a similarly deep service line portfolio.
• Idaho Urologic Institute: Multi-physician independent urology practice in Boise, Idaho offering a comparable mix of advanced urologic services including robotic surgery and BPH treatments. Highly analogous as a regional independent group in a similar Mountain West market.
• Urology Associates of North Texas: Independent physician-led urology group with comprehensive diagnostic and advanced surgical capabilities. Comparable as an established independent urology specialty group with multiple providers and advanced technology offerings.

Broad incumbents

• Mayo Clinic Urology: Academic / large-system urology practice within Mayo Clinic offering highly advanced urologic oncology, robotic, and reconstructive care. Comparable in offering advanced urologic services and being a referral destination, although operating at an entirely different scale.
• Mercy Health Urology: Large Catholic health system with employed urology practices across multiple states. Comparable in that it offers the same spectrum of urologic services, but operates as part of a much larger system rather than as an independent specialty group.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Profiles9 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Five Valley Urology