Individual provider Active NPI

Michael Salvatore Montileone, MD

  • Diagnostic Radiology Physician
  • Williamsburg, VA
National Provider Identifier
1164537213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101230446 Issued in VA
Practice address
100 Sentara Circle
Sentara Williamsburg Regional Medical Center
Williamsburg, VA 23188
Phone
(757) 984-7890
Fax
(757) 984-7891
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101230446 VA Primary

Addresses

Primary practice location

100 Sentara Circle
Sentara Williamsburg Regional Medical Center
Williamsburg, VA 23188

Mailing address

PO Box 12127
Tidewater Diagnostic Imaging
Newport News, VA 23612-2121
Phone (757) 867-6101

Other identifiers 1

IdentifierTypeStateIssuer
7204868MedicaidVA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101230446VAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164537213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12127",
            "address_2": "TIDEWATER DIAGNOSTIC IMAGING",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236122121",
            "telephone_number": "757-867-6101",
            "fax_number": "757-867-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SENTARA CIRCLE",
            "address_2": "SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23188",
            "telephone_number": "757-984-7890",
            "fax_number": "757-984-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTILEONE",
        "first_name": "MICHAEL",
        "middle_name": "SALVATORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101230446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7204868",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

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.

Verify at the official NPI Registry.