NPIMap

Individual provider Active NPI

Daniel B Spoon, M.D.

  • Interventional Cardiology Physician
  • Missoula, MT
National Provider Identifier
1104021781
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
49943 Issued in MT
Practice address
500 W Broadway St Ste 320
Missoula, MT 59802-4003
Phone
(406) 329-5615
Fax
(406) 329-2791
NPI assigned
Jun 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 49943 MT
Interventional Cardiology Physician 207RI0011X 49943 MT Primary

Addresses

Primary practice location

500 W Broadway St Ste 320
Missoula, MT 59802-4003

Mailing address

500 W Broadway St Ste 320
Missoula, MT 59802-4003
Phone (406) 329-5615

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dspoon494181@wm.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817002475 MT Practitioner - Interventional Cardiology 4486790110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Mayo Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Suite 320
Missoula, MT 59802-4031
Phone (406) 329-5615

Hospital & facility affiliations

  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014
  • Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012
  • St Peters Health Hospital, Helena, MT, CCN 270003
  • Steele Memorial Medical Center Hospital, Salmon, ID, CCN 131305
  • Providence St Joseph Medical Center Hospital, Polson, MT, CCN 271343

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting74
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49943MTMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Cardiovascular Disease CurrentSince Aug 22, 2016 Accepting new patients
Providence St Joseph Medical Center CurrentSince Oct 30, 2018 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt Cardiovascular Disease CurrentSince Aug 22, 2016 Accepting new patients
Credena Health LLC CurrentSince Oct 30, 2018 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Providence Health & Services Mt Cardiovascular Disease Past Accepting new patients

Locations

2829 Great Northern Loop
Ste 300
Missoula, MT 59808
Phone (406) 541-7000

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

63351 US Highway 93
Ronan, MT 59864
Phone (406) 676-5680

Organizations & group practices 7

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1104021781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST STE 320",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024003",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST STE 320",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024003",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOON",
        "first_name": "DANIEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MT",
            "license": "49943",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MT",
            "license": "49943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dspoon494181@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "500 W Broadway St Ste 320",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598024003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.