Individual provider Active NPI

Matthew Joseph Montanarella

  • Diagnostic Radiology Physician
  • Detroit, MI
National Provider Identifier
1851978092
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101027811 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-5111
Fax
(313) 745-3500
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 5101027811 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

PO Box 18998
Belfast, ME 04915-4084
Phone (469) 803-3000

Other practice location 1

655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 244-4225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 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
I20260409000528 FL Practitioner - Diagnostic Radiology 4587068598 Reassigns benefits to 1 organization
I20260518001025 MI Practitioner - Diagnostic Radiology 4587068598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

5191 1St Coast Tech Pkwy
Jacksonville, FL 32224-0609
Phone (904) 427-6991

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5101027811MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan PastSince Aug 23, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmontanarella475075@direct.shands.ufl.edu

Organizations & group practices 2

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 2

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1851978092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18998",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "469-803-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-5111",
            "fax_number": "313-745-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-4225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTANARELLA",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101027811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.