Individual provider Active NPI

Mark L. Sanz, MD

  • Interventional Cardiology Physician
  • Missoula, MT
National Provider Identifier
1790714251
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
6285 Issued in MT
Practice address
500 W Broadway St
Suite 320
Missoula, MT 59802-4003
Phone
(406) 329-5615
Fax
(406) 329-5606
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 6285 MT
Interventional Cardiology Physician 207RI0011X MD60556860 WA
Interventional Cardiology Physician 207RI0011X 6285 MT Primary

Addresses

Primary practice location

500 W Broadway St
Suite 320
Missoula, MT 59802-4003

Mailing address

500 W Broadway St
Suite 320
Missoula, MT 59802-4003
Phone (406) 329-5615

Other identifiers 1

IdentifierTypeStateIssuer
0040647MedicaidMT

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
6285MTMDInterventional Cardiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1790714251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "address_2": "SUITE 320",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024003",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "address_2": "SUITE 320",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024003",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANZ",
        "first_name": "MARK",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MT",
            "license": "6285",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD60556860",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MT",
            "license": "6285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0040647",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.