NPIMap

Individual provider Active NPI

Carlos F Montoya, MD

  • Ophthalmology Physician
  • Huntington Park, CA
National Provider Identifier
1063420974
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A40547 Issued in CA
Practice address
2746 E Florence Ave
Huntington Park, CA 90255-5747
Phone
(323) 583-4567
Fax
(323) 583-4560
NPI assigned
Aug 4, 2006
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A40547 CA Primary
General Practice Physician 208D00000X A40547 CA

Addresses

Primary practice location

2746 E Florence Ave
Huntington Park, CA 90255-5747

Mailing address

2746 E Florence Ave
Huntington Park, CA 90255-5747
Phone (323) 583-4567

Other practice location 1

1532 San Bernardino Ave Ste B7
Pomona, CA 91767-3559
Phone (909) 301-4041

Other identifiers 1

IdentifierTypeStateIssuer
GR0092651MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040206000249 CA Practitioner - Ophthalmology 0244131449 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40547CAMDGeneral Practice Dentistry
A40547CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
De la Pena Eye Clinic, a Medical Group, Inc. Ophthalmology CurrentSince Feb 20, 2020 Accepting new patients
De la Pena Eye Clinic, a Medical Group, Inc Ophthalmology Current Accepting new patients
Downey Laser Institute, Inc. Current Accepting new patients
St Lucia Eye Center Medical Corp Ophthalmology CurrentSince Jan 1, 2004 Accepting new patients
De la Pena Eye Clinic, a Medical Group, Inc Ophthalmology CurrentSince Feb 20, 2020 Accepting new patients
CMMP Clinica de Ojos Current Accepting new patients
Clinica de Los Angeles Medical Group Past Accepting new patients
De la Pena Eye Clinic, a Medical Group, Inc. Ophthalmology Past Accepting new patients
Barlow Respiratory Hospital Past Accepting new patients

Locations

2746 E Florence Ave
Huntington Pk, CA 90255
Phone (323) 582-1780

2446 W Whittier Blvd
Montebello, CA 90640
Phone (213) 728-5500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1063420974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555747",
            "telephone_number": "323-583-4567",
            "fax_number": "323-583-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2746 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555747",
            "telephone_number": "323-583-4567",
            "fax_number": "323-583-4560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1532 San Bernardino Ave Ste B7",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917673559",
            "country_code": "US",
            "telephone_number": "909-301-4041",
            "fax_number": "909-301-4042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "CARLOS",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A40547",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A40547",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092651",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

Verify at the official NPI Registry.