Individual provider Active NPI

Mark William Elliott, M.D.

  • Vascular & Interventional Radiology Physician
  • Missoula, MT
National Provider Identifier
1053349415
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
7226 Issued in MT
Practice address
3205 S Russell St
Missoula, MT 59801-8536
Phone
(406) 721-4906
NPI assigned
Jun 28, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 7226 MT
Vascular & Interventional Radiology Physician 2085R0204X 7226 MT Primary

Addresses

Primary practice location

3205 S Russell St
Missoula, MT 59801-8536

Mailing address

7533 Highline CT
Missoula, MT 59808-8635
Phone (406) 542-8422

Other identifiers 1

IdentifierTypeStateIssuer
0103389MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100812000644 MT Practitioner - Diagnostic Radiology 0143315002 Reassigns benefits to 4 organizations
I20170321002550 WA Practitioner - Diagnostic Radiology 0143315002 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integra Imaging PSGroup PAC ID 1355593062, 126 clinicians
Inland Imaging Associates PSGroup PAC ID 7810327210, 124 clinicians

Practice addresses (Care Compare)

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (509) 363-7745

2419 Mullan Rd
Suite D
Missoula, MT 59808-1856
Phone (509) 363-7788

2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone (509) 363-7788

500 W Broadway St
Missoula, MT 59802-4008
Phone (509) 363-7788

6 13TH Ave E
Polson, MT 59860-5315
Phone (209) 363-7788

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7226MTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia County Hospital District CurrentSince Jun 2, 2024 Accepting new patients
Advanced Imaging at Community Medical Center, LLC CurrentSince Apr 1, 2003 Accepting new patients
The Polyclinic PLLC CurrentSince May 20, 2017 Accepting new patients
Integra Imaging, PS Diagnostic Radiology CurrentSince Nov 1, 2016 Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Integra Imaging, PS Diagnostic Radiology CurrentSince Mar 7, 2017 Accepting new patients
Grant County Public Hospital District 2 CurrentSince Mar 1, 2017 Accepting new patients
Bozeman Diagnostics LLC CurrentSince Jul 1, 2023 Accepting new patients
Moses Lake Community Health Center CurrentSince Mar 11, 2017 Accepting new patients
Moses Lake Community Health Center CurrentSince Mar 11, 2017 Accepting new patients
The Polyclinic PLLC CurrentSince May 20, 2017 Accepting new patients
Columbia County Hospital District CurrentSince Jun 2, 2024 Accepting new patients
Inland Imaging LLC Diagnostic Radiology CurrentSince Dec 1, 2016 Accepting new patients
Inland Imaging Associates PS Diagnostic Radiology CurrentSince May 1, 2020 Accepting new patients

Locations

2419 Mullan Rd
Ste D
Missoula, MT 59808
Phone (406) 540-1512

2740 South Ave W
Missoula, MT 59804
Phone (406) 728-6010

2803 South Ave W
Missoula, MT 59804
Phone (406) 327-3950

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

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

500 E Webster Ave
Chewelah, WA 99109
Phone (509) 482-2154

1012 S 3rd St
Dayton, WA 99328
Phone (509) 382-2531

411 Fortuyn Rd
Grand Coulee, WA 99133
Phone (509) 633-1753

605 S Coolidge St
#101
Moses Lake, WA 98837
Phone (509) 765-0674

908 10th Ave SW
Quincy, WA 98848
Phone (509) 787-3503

1145 Broadway
Seattle, WA 98122

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

525 S Cowley St
Spokane, WA 99202
Phone (509) 625-3397

801 S Stevens St
Spokane, WA 99204
Phone (206) 621-4316

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 8

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1053349415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7533 HIGHLINE CT",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598088635",
            "telephone_number": "406-542-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 S RUSSELL ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018536",
            "telephone_number": "406-721-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MT",
            "license": "7226",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MT",
            "license": "7226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103389",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.