NPIMap

Douglas D. Montgomery, M.D.

Individual provider Active NPI Diagnostic Radiology Physician · Hartford, CT

NPI 1477539484 · NPPES record last updated Jun 12, 2018

Key facts

NPI
1477539484
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
041348 (CT)
Practice address
85 Seymour St
Suite 200
Hartford, CT 06106
Phone
(860) 289-3375
Fax
(860) 560-2849
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 14

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 7

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

Medicare Care Compare profile

Specialty
Diagnostic Radiology
Education
Albany Medical College of Union University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Imaging Partners LLC (105 clinicians)
Jefferson Radiology PC (121 clinicians)
Farmington Imaging Center LLC (68 clinicians)
Tic LLC (52 clinicians)

Practice addresses (Care Compare)

100 Simsbury Rd
Avon, CT 06001-3793
Phone (860) 289-3375

1260 Silas Deane Hwy
Suite 104
Wethersfield, CT 06109-4363
Phone (860) 289-3375

1260 Silas Deane Hwy 100
Wethersfield, CT 06109-4363
Phone 860289337587099

130 Division St
Derby, CT 06418-1326
Phone (203) 735-7421

2800 Tamarack Ave
Suite 105
South Windsor, CT 06074-5553
Phone (860) 289-3375

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

399 Farmington Ave
Farmington, CT 06032-1936
Phone (860) 289-3375

6 Fieldstone CMNS
Suite E
Tolland, CT 06084-3419
Phone (860) 896-4848

704 Hebron Ave
Suite 100
Glastonbury, CT 06033-5020
Phone (860) 289-3375

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 289-3375

85 Seymour St
Suite 200
Hartford, CT 06106-5509
Phone (860) 289-3375

941 Farmington Ave
West Hartford, CT 06107-2203
Phone (860) 289-3375

Hospital & facility affiliations

  • Hartford Hospital Hospital · Hartford, CT · CCN 070025
  • Day Kimball Hospital Hospital · Putnam, CT · CCN 070003
  • Griffin Hospital Hospital · Derby, CT · CCN 070031
  • Manchester Memorial Hospital Hospital · Manchester, CT · CCN 070027
  • Middlesex Hospital Hospital · Middletown, CT · CCN 070020

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CT, MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051014000104 CT Practitioner - Diagnostic Radiology 4880598606 Reassigns benefits to 4 organizations
I20110919000667 MA Practitioner - Diagnostic Radiology 4880598606 Reassigns benefits to 7 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
041348CTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc Current
since Apr 1, 2020		 Accepting new patients
Farmington Imaging Center, LLC Diagnostic Radiology Current
since Oct 3, 2016		 Accepting new patients
Tic, LLC Diagnostic Radiology Current
since Sep 1, 2016		 Accepting new patients
Compass Medical PC Current
since Apr 4, 2022		 Accepting new patients
Connecticut Imaging Partners, LLC Diagnostic Radiology Current
since Oct 1, 2005		 Accepting new patients
Chelmsford MRI, P.C. Diagnostic Radiology Current
since Feb 26, 2020		 Accepting new patients
Steward Medical Group, Inc Current
since Apr 1, 2020		 Accepting new patients
Compass Medical PC Current
since Apr 4, 2022		 Accepting new patients
Chelmsford MRI, P.C. Diagnostic Radiology Current
since Feb 26, 2020		 Accepting new patients
Tolland Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
South Jersey Radiology Associates P a Diagnostic Radiology Past Accepting new patients
Jefferson University Physicians Diagnostic Radiology Past Accepting new patients
Diagnostic Imaging Inc Diagnostic Radiology Past Accepting new patients

Locations

100 Simsbury Rd
Ste 101
Avon, CT 06001
Phone (860) 678-8527

399 Farmington Ave
Lowr 1
Farmington, CT 06032

704 Hebron Ave
Ste 100
Glastonbury, CT 06033
Phone (860) 659-9595

85 Seymour St
Ste 200
Hartford, CT 06106
Phone (860) 246-6589

111 Founders Plz
Ste 400
Hartford, CT 06108
Phone (860) 291-6554

6 Fieldstone Cmns
Ste E
Tolland, CT 06084
Phone (860) 896-4847

941 Farmington Ave
West Hartford, CT 06107
Phone (860) 231-1900

1260 Silas Deane Hwy
Ste 104
Wethersfield, CT 06109
Phone (860) 563-7844

187 Billerica Rd
Chelmsford, MA 01824
Phone (978) 250-1866

200 Providence Hwy
Ste 210
Dedham, MA 02026
Phone (781) 329-0600

1 Donalds Way
Ste 105
East Bridgewater, MA 02333
Phone (508) 350-2200

1 Donalds Way
Ste 102
East Bridgewtr, MA 02333
Phone (508) 350-2100

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

8 Commerce Blvd
Middleboro, MA 02346
Phone (774) 260-9300

54 Miller St
Ste 200
Quincy, MA 02169
Phone (617) 481-3200

54 Miller St
Ste 201
Quincy, MA 02169
Phone (617) 481-3100

3640 Main St
Ste 101
Springfield, MA 01107
Phone (413) 781-9000

115 W Silver St
Westfield, MA 01085
Phone (413) 562-3444

Interoperability endpoints

  • Direct secure messaging: douglas.montgomery@xdr.hhchealthdirect.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 041348 CT Yes

Addresses

Primary practice location

85 Seymour St
Suite 200
Hartford, CT 06106

Mailing address

111 Founders PLZ
Suite 400
East Hartford, CT 06108-3212
Phone (860) 291-6554

Other identifiers

IdentifierTypeStateIssuer
001413484MedicaidCT
010041348CT01OtherCTANTHEM BC/BS
A2516306OtherCTOXFORD

Other providers in Hartford, CT

All providers in Hartford, CT · Diagnostic Radiology Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.