Active NPI
Anthony James Menichino, M.D.
- Surgery Physician
- Fort Harrison, MT
National Provider Identifier
1083795553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 126591
- Practice address
- 600 Williams Street
Fort Harrison, MT 59636 - Phone
- (406) 447-7691
- NPI assigned
- Oct 18, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 126591 | NY | Primary |
Addresses
Primary practice location
600 Williams Street
Fort Harrison, MT 59636
Mailing address
PO Box 1002
Fort Harrison, MT 59636-1002
Phone (406) 447-7691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126591 | NY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083795553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1002",
"city": "FORT HARRISON",
"state": "MT",
"postal_code": "596361002",
"telephone_number": "406-447-7691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WILLIAMS STREET",
"city": "FORT HARRISON",
"state": "MT",
"postal_code": "59636",
"telephone_number": "406-447-7691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENICHINO",
"first_name": "ANTHONY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "126591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Harrison, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.