Individual provider Active NPI

Kyle Laird Dale, MD

  • Vascular & Interventional Radiology Physician
  • Missoula, MT
National Provider Identifier
1295916120
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
12028 Issued in MT
Practice address
3205 S Russell St
Missoula, MT 59801-8536
Phone
(406) 721-4906
NPI assigned
Nov 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 12028 MT Primary

Addresses

Primary practice location

3205 S Russell St
Missoula, MT 59801-8536

Mailing address

3205 S Russell St
Missoula, MT 59801-8536
Phone (406) 721-4906

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
I20090618000778 MT Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1153472857 Reassigns benefits to 4 organizations
I20170313000109 WA Practitioner - Diagnostic Radiology 1153472857 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inland Imaging Associates PSGroup PAC ID 7810327210, 124 clinicians
Integra Imaging PSGroup PAC ID 1355593062, 126 clinicians
Inland Imaging LLCGroup PAC ID 6608763016, 128 clinicians

Practice addresses (Care Compare)

1012 S 3Rd St
Dayton, WA 99328-1606
Phone (509) 382-2531

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (509) 363-7788

1450 1St Ave SW
Quincy, WA 98848-1695
Phone (509) 787-6423

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

525 S Cowley St
Spokane, WA 99202-1381
Phone (509) 747-4455

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

605 S Coolidge St
Suite 101
Moses Lake, WA 98837-1893
Phone (509) 765-0674

801 S Stevens St
Spokane, WA 99204-2654
Phone (509) 363-7745

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12028MTMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Imaging at Community Medical Center, LLC CurrentSince Jan 1, 2015 Accepting new patients
Columbia County Hospital District CurrentSince Jan 20, 2026 Accepting new patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients
Okanogan Douglas County Hospital Dist1 CurrentSince Apr 15, 2022 Accepting new patients
Inland Imaging LLC CurrentSince Nov 1, 2016 Accepting new patients
Bozeman Diagnostics LLC CurrentSince Jul 1, 2023 Accepting new patients
Inland Imaging Associates PS CurrentSince May 1, 2020 Accepting new patients
The Polyclinic PLLC CurrentSince May 20, 2017 Accepting new patients
Moses Lake Community Health Center CurrentSince Feb 18, 2017 Accepting new patients
Integra Imaging, PS CurrentSince Nov 1, 2016 Accepting new patients
Grant County Public Hospital District 2 CurrentSince Feb 13, 2017 Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Okanogan Douglas County Hospital Dist 1 CurrentSince Apr 15, 2022 Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
The Polyclinic PLLC Current Accepting new patients
Moses Lake Community Health Center CurrentSince Feb 18, 2017 Accepting new patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients

Locations

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

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

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

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

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

1145 Broadway
Seattle, WA 98122

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

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

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

Organizations & group practices 17

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.

View all 17

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": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1295916120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 S RUSSELL ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018536",
            "telephone_number": "406-721-4906"
        },
        {
            "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": "DALE",
        "first_name": "KYLE",
        "middle_name": "LAIRD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MT",
            "license": "12028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.