Individual provider Active NPI

August Denicco, MD

  • Anesthesiology Physician
  • Missoula, MT
National Provider Identifier
1013234665
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MED-PHYS-LIC-60262 Issued in MT
Practice address
2825 Stockyard Rd Ste I-200
Missoula, MT 59808-1548
Phone
(406) 728-8420
Fax
(406) 541-8430
NPI assigned
Apr 22, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X DR0053632 CO
Anesthesiology Physician 207L00000X MED-PHYS-LIC-60262 MT Primary
Internal Medicine Physician 207R00000X MT196857 PA

Addresses

Primary practice location

2825 Stockyard Rd Ste I-200
Missoula, MT 59808-1548

Mailing address

11600 W 2ND PL
Lakewood, CO 80228-1527
Phone (720) 321-0000

Other practice location 1

11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (720) 321-0000

Other practice location 2

301 S 7th Ave
West Reading, PA 19611-1410
Phone (610) 988-8198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180118002005 MT Practitioner - Anesthesiology 4880811793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Jefferson Medical College of Thomas Jefferson University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missoula Anesthesiology PCGroup PAC ID 5597669960, 45 clinicians

Practice addresses (Care Compare)

500 W Broadway
St Patrick Hospital
Missoula, MT 59802-4008
Phone (406) 543-7271

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR0053632COMDAnesthesiology Physician
MT196857PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missoula Anesthesiology, P.C. Anesthesiology CurrentSince Mar 17, 2018 Accepting new patients
Ma Critical Care Services, PC Past Accepting new patients

Locations

2360 Mullan Rd
Missoula, MT 59808
Phone (406) 541-4263

2825 Stockyard Rd
Ste I-200
Missoula, MT 59808
Phone (406) 728-4100

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2833 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 542-6559

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

902 N Orange St
Missoula, MT 59802
Phone (406) 327-3300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013234665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281527",
            "telephone_number": "720-321-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE I-200",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081548",
            "telephone_number": "406-728-8420",
            "fax_number": "406-541-8430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281527",
            "country_code": "US",
            "telephone_number": "720-321-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 S 7th Ave",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196111410",
            "country_code": "US",
            "telephone_number": "610-988-8198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENICCO",
        "first_name": "AUGUST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "DR0053632",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-60262",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT196857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.