Individual provider Active NPI

Edward H Dumontier, M.D.

  • Family Medicine Physician
  • Port Angeles, WA
National Provider Identifier
1548247315
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61293488 Issued in WA
Practice address
907 Georgiana St
Port Angeles, WA 98362-3911
Phone
(360) 565-0999
Fax
(360) 565-0852
NPI assigned
Dec 22, 2005
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R3J59 MO
Family Medicine Physician 207Q00000X MD61293488 WA Primary

Addresses

Primary practice location

907 Georgiana St
Port Angeles, WA 98362-3911

Mailing address

PO Box 850
Port Angeles, WA 98362-0146
Phone (360) 565-0999

Other practice location 1

840 E Hill Ave
Moses Lake, WA 98837-2238
Phone (509) 663-8711

Other practice location 2

3141 Centennial Blvd
Colorado Springs, CO 80907-4094
Phone (573) 330-1128

Other practice location 3

1105 W Liberty St
Suite 4050
Farmington, MO 63640-1921
Phone (573) 756-7844

Other identifiers 1

IdentifierTypeStateIssuer
202612313MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.56 of 100Reported as group
Quality
80.73
Promoting interoperability
80
Improvement activities
40
Cost
74.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Parkland Health Clinic Family Medicine CurrentSince Nov 1, 1997 Accepting new patients
Physician Groups LC Family Medicine Past Accepting new patients
Clallam County Public Hospital District 2 PastSince Jan 8, 2024 Accepting new patients
Physician Groups LC Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1105 W Liberty St
Ste 4050
Farmington, MO 63640
Phone (573) 756-7844

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1548247315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620146",
            "telephone_number": "360-565-0999",
            "fax_number": "360-565-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 GEORGIANA ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623911",
            "telephone_number": "360-565-0999",
            "fax_number": "360-565-0852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 E Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988372238",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3141 Centennial Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809074094",
            "country_code": "US",
            "telephone_number": "573-330-1128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 W Liberty St",
            "address_2": "SUITE 4050",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636401921",
            "country_code": "US",
            "telephone_number": "573-756-7844",
            "fax_number": "573-454-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUMONTIER",
        "first_name": "EDWARD",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R3J59",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61293488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202612313",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.