Individual provider Active NPI

Anthony D'Amico, M.D.

  • Diagnostic Radiology Physician
  • Missoula, MT
National Provider Identifier
1689794083
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11595 Issued in MT
Practice address
3205 S Russell St
Missoula, MT 59801-8536
Phone
(406) 721-4906
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

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
Diagnostic Radiology Physician 2085R0202X 11595 MT Primary

Addresses

Primary practice location

3205 S Russell St
Missoula, MT 59801-8536

Mailing address

10400 Upland TRL
Missoula, MT 59804-9201
Phone (406) 207-7582

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
I20080331000112 MT Practitioner - Diagnostic Radiology 1850477944 Reassigns benefits to 4 organizations
I20170123002219 WA Practitioner - Diagnostic Radiology 1850477944 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians
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)

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

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

1200 Westwood Dr
Hamilton, MT 59840-2345
Phone (509) 363-7788

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

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
11595MTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Imaging Associates PS Diagnostic Radiology CurrentSince May 1, 2020 Accepting new patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients
Bozeman Diagnostics LLC CurrentSince Dec 1, 2025 Accepting new patients
Columbia County Hospital District CurrentSince Jun 30, 2021 Accepting new patients
The Polyclinic PLLC Current Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Okanogan Douglas County Hospital Dist 1 Current Accepting new patients
Columbia County Hospital District CurrentSince Jan 20, 2026 Accepting new patients
Okanogan Douglas County Hospital Dist1 CurrentSince Apr 15, 2022 Accepting new patients
Moses Lake Community Health Center CurrentSince Jan 11, 2017 Accepting new patients
Integra Imaging, PS Diagnostic Radiology CurrentSince Nov 1, 2016 Accepting new patients
The Polyclinic PLLC CurrentSince Feb 13, 2017 Accepting new patients
Inland Imaging LLC Diagnostic Radiology CurrentSince Nov 1, 2016 Accepting new patients
Moses Lake Community Health Center CurrentSince Jan 11, 2017 Accepting new patients
Okanogan Douglas County Hospital Dist 1 CurrentSince Apr 15, 2022 Accepting new patients
Grant County Public Hospital District 2 CurrentSince Jan 11, 2017 Accepting new patients
Advanced Imaging at Community Medical Center, LLC CurrentSince Jun 1, 2008 Accepting new patients

Locations

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

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

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

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

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

1145 Broadway
Seattle, WA 98122

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

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1689794083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 UPLAND TRL",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598049201",
            "telephone_number": "406-207-7582"
        },
        {
            "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": "D'AMICO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MT",
            "license": "11595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.