Active NPI
Mark L. Sanz, MD
- Interventional Cardiology Physician
- Missoula, MT
National Provider Identifier
1790714251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 6285
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0040647 | Medicaid | MT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6285 | MT | MD | Interventional 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.