Diane M Eodice, D.O.
Individual provider Active NPI Family Medicine Physician · Helena, MT
NPI 1023098696 · NPPES record last updated Dec 3, 2012
Key facts
- NPI
- 1023098696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 9893 (MT)
- Practice address
- 820 N Montana Ave
Helena, MT 59601-3856 - Phone
- (406) 443-7733
- Fax
- (406) 443-8292
- NPI assigned
- Jan 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050106000635 | MT | Practitioner - Family Practice | 7012965031 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9893 | MT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pureview Health Center | Past | Accepting new patients | |
| Niagara Falls Memorial Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9893 | MT | Yes |
Addresses
Primary practice location
820 N Montana Ave
Helena, MT 59601-3856
Mailing address
820 North Montana Avenue
Helena, MT 59601-4926
Phone (406) 443-7733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0092667 | Medicaid | MT | |
| 0098935 | Other | MT | BCBS |
Other providers in Helena, MT
- Mallory K Emig
- Emmaus Counseling Services of Montana LLC
- Kristen Enblom
- Cathryn Diane English-Straub
- James Verrill English
- Paul A Eodice
- Joshua Matthias Erekson
- Cindy Erhardt
- Cori Erickson
- Meghan Ann Erickson
All providers in Helena, MT · Family Medicine Physician in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.