NPIMap

Individual provider Active NPI

Mitchell C Marzo, M.D.

  • Internal Medicine Physician
  • Kalispell, MT
National Provider Identifier
1851594626
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26272 Issued in MT
Practice address
310 Sunnyview LN
Kalispell, MT 59901-3129
Phone
(406) 751-5310
Fax
(406) 751-3068
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26272 MT Primary
Hospitalist Physician 208M00000X 26272 MT

Addresses

Primary practice location

310 Sunnyview LN
Kalispell, MT 59901-3129

Mailing address

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 752-5111

Other practice location 1

3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone (907) 228-5171

Other identifiers 3

IdentifierTypeStateIssuer
1851594626MedicaidID
1851594626MedicaidMT
1851594626MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc
Direct Messaging Address NorthValleyHospital@nvh.medalliesdirect.net North Valley Hospital, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130926000864 MT Practitioner - Internal Medicine 9133301591 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Colorado School of Medicine, Denver, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logan Health - WhitefishGroup PAC ID 9335033687, shared by 6 NPIs, 48 clinicians
St Johns Lutheran Hospital IncGroup PAC ID 1557255676, 34 clinicians
Kalispell Regional Medical Center IncGroup PAC ID 5294644381, 422 clinicians

Practice addresses (Care Compare)

1600 Hospital Way
Whitefish, MT 59937-7849
Phone (406) 863-3500

209 Health Park Dr
Libby, MT 59923-2001
Phone (406) 283-7000

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 751-6725

Hospital & facility affiliations

  • Logan Health - Whitefish Hospital, Whitefish, MT, CCN 271336
  • Cabinet Peaks Medical Center Hospital, Libby, MT, CCN 271320
  • Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051
  • Cabinet Peaks Medical Center Nursing home, CCN 27Z320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26272MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
St John'S Lutheran Hospital Physician'S Services Current Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Apr 1, 2016 Accepting new patients
St. John'S Lutheran Hospital, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Apr 1, 2016 Accepting new patients
Logan Health - Whitefish Past Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Past Accepting new patients

Locations

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

209 Health Park Dr
Libby, MT 59923
Phone (406) 283-7000

1600 Hospital Way
Whitefish, MT 59937
Phone (406) 863-3500

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org
  • Direct secure messaging: mmarzo440163@direct.peacehealth.org

Organizations & group practices 11

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 10

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1851594626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-752-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-751-5310",
            "fax_number": "406-751-3068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Tongass Ave",
            "address_purpose": "LOCATION",
            "city": "Ketchikan",
            "state": "AK",
            "postal_code": "999015746",
            "country_code": "US",
            "telephone_number": "907-228-5171",
            "fax_number": "907-228-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARZO",
        "first_name": "MITCHELL",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "26272",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MT",
            "license": "26272",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851594626",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851594626",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851594626",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "310 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NorthValleyHospital@nvh.medalliesdirect.net",
            "affiliation": "Y",
            "affiliationName": "North Valley Hospital, Inc.",
            "address_1": "1600 Hospital Way",
            "city": "Whitefish",
            "state": "MT",
            "country_code": "US",
            "postal_code": "59937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.