DR. MICHAEL C DICELLO (NPI# 1720083173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720083173 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL C DICELLO |
| Credential | MD |
| Practice Address |
1188 N 15th Ave Ste 3 Bozeman MT 59715-3290 |
| Practice Telephone | (406) 582-1111 |
| Practice Fax Number | 4065821112 |
| Mailing Telephone | (406) 582-1111 |
| Mailing Fax Number | 4065821112 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2017-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 11976 | MT | Allopathic & Osteopathic Physicians |
| N | 207K00000X | Allergy & Immunology | 42-000-9879 | VT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | BLUE CROSS BLUE SHIELD VT | 48079 | 01 |
| NY | BCBS NORTHEAST NEW YORK | 96G431 | 01 |
| VT | CIGNA | 7525992-001 | 01 |
| VT | 0VN1993 | 05 | |
| NY | 01961568 | 05 | |
| VT | MVP | 03V100 | 01 |
| Street Address |
1188 N 15TH AVE STE 3 |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59715-3290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356637656 | Equanimity Health Care, P.C. | Clinic/Center | 1188 N 15th Ave Ste 3, Bozeman, MT 59715-3290 | 2011-06-24 |
| 1427037290 | Cindy K Feddes | Nurse Practitioner | 1188 N 15th Ave Ste 3, Bozeman, MT 59715-3290 | 2006-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152288 | Ch Mh Services (il), LLC | Clinic/Center | 233 E Main St Suite 401, Bozeman, MT 59715 | 2020-10-22 |
| 1134735269 | Montana Therapy and Consulting Pllc | Social Worker | 110 S Grand Ave, Floor 2, Bozeman, MT 59715 | 2020-09-23 |
| 1831715994 | Alyson Raph | Student in an Organized Health Care Education/Training Program | 1 Anna Pearl Sherrick Hal, Bozeman, MT 59715 | 2020-06-24 |
| 1639702780 | Miranda Shields | Massage Therapist | 1001 W. Oak St. Bldg C Ste 210, Bozeman, MT 59715 | 2020-02-18 |
| 1154988590 | Christina Yancy | Massage Therapist | Bldg C, Ste 210, 1001 W Oak St, Bozeman, MT 59715 | 2019-05-21 |
| 1962068767 | Julie A Hisey | Physical Therapist | 1700 W. Koch, Suite 12, Bozeman, MT 59715 | 2019-05-16 |
| 1639631633 | Joshua Wallace | Massage Therapist | 1001 W Oak St, Bldg. C Ste. 210, Bozeman, MT 59715 | 2019-04-01 |
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1194280875 | Erica Kotick | Counselor | 2246 Boot Hill Court, Suite 4, Bozeman, MT 59715 | 2019-02-06 |
| 1194291609 | Providence Mental Health Pllc | Social Worker | 2246 Boot Hill Ct. Unit #4, Bozeman, MT 59715 | 2018-10-23 |
| Find all providers in zip 59715 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316999824 | Michael C Zacharisen | Allergy & Immunology | 4265 Fallon St Ste 3a, Bozeman, MT 59718-6797 | 2006-05-16 |
| 1386633220 | Alan A Wanderer | Allergy & Immunology | 2055 N 22nd Ave, Ste 1, Bozeman, MT 59718-2783 | 2005-10-13 |
| 1619347390 | Bozeman Health Deaconess Hospital | Allergy & Immunology | 915 Highland Blvd, Bozeman, MT 59715-6902 | 2015-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629208772 | Montana Allergy, Pllc | Allergy & Immunology | 2900 12th Ave. N, #302e, Billings, MT 59101-7515 | 2009-07-23 |
| 1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
| 1073642831 | Maciej Tomaszewski | Allergy & Immunology | 1020 No 27th St, #315, Billings, MT 59101 | 2007-03-05 |
| 1073605200 | Carl Edward Thornblade | Allergy & Immunology | 2801 Great Northern Loop, Suite 101, Missoula, MT 59808-1745 | 2006-09-28 |
| 1831126747 | Donald Nevin Gillespie | Allergy & Immunology | 610 W Spruce St, Missoula, MT 59802-4009 | 2006-06-27 |
| 1447244454 | Mary Irene B Feria | Allergy & Immunology | 430 Windward Way, Suite 100, Kalispell, MT 59901-2619 | 2005-09-06 |
| 1942820295 | United Immunology and Allergy LLC | Allergy & Immunology | 420 1st St E, Polson, MT 59860-2106 | 2020-04-16 |
| 1144512096 | Juan Armando Adams | Allergy & Immunology | 801 N 29th St, Billings, MT 59101-0905 | 2011-05-11 |
| 1083882187 | Montana Allergy and Asthma Spec | Allergy & Immunology | 2900 12th Ave N, #302e, Billings, MT 59101 | 2008-02-12 |
| 1194927293 | Summer Elizabeth Monforte | Allergy & Immunology | 2550 E Broadway St, Helena, MT 59601-4905 | 2007-06-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.