Individual provider Active NPI

Kayla Megan Bo Montemayor, PA

  • Physician Assistant
  • San Juan, TX
National Provider Identifier
1073206777
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20333 Issued in TX
Practice address
1205 N Raul Longoria Rd Ste H
San Juan, TX 78589-3721
Phone
(956) 702-0444
Fax
(956) 702-3332
NPI assigned
May 30, 2023
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20333 TX Primary

Addresses

Primary practice location

1205 N Raul Longoria Rd Ste H
San Juan, TX 78589-3721

Mailing address

712 S Cage Blvd
Pharr, TX 78577-5446
Phone (956) 783-1900

Other practice location 1

712 S Cage Blvd
Pharr, TX 78577-5446
Phone (956) 783-1900

Other identifiers 1

IdentifierTypeStateIssuer
1073206777MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260410003837 TX Practitioner - Physician Assistant 7517432115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Univeristy of Texas Rio Grande Valley Med School, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norma a Iglesias, MD PA and AssociatesGroup PAC ID 3072410117, 8 clinicians

Practice addresses (Care Compare)

1205 N Raul Longoria Rd
Suite H
San Juan, TX 78589-3721
Phone (956) 783-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20333TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Norma a Iglesias, MD PA and Associates CurrentSince Apr 1, 2026 Accepting new patients
Eduardo Guzman MD PA PastSince Apr 1, 2026 Accepting new patients

Locations

712 S Cage Blvd
Pharr, TX 78577
Phone (956) 783-1900

1205 N Raul Longoria Rd
Ste H
San Juan, TX 78589
Phone (956) 702-0444

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, 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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1073206777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S CAGE BLVD",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785775446",
            "telephone_number": "956-783-1900",
            "fax_number": "956-783-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N RAUL LONGORIA RD STE H",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893721",
            "telephone_number": "956-702-0444",
            "fax_number": "956-702-3332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "712 S Cage Blvd",
            "address_purpose": "LOCATION",
            "city": "Pharr",
            "state": "TX",
            "postal_code": "785775446",
            "country_code": "US",
            "telephone_number": "956-783-1900",
            "fax_number": "956-783-0291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTEMAYOR",
        "first_name": "KAYLA",
        "middle_name": "MEGAN BO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA20333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073206777",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, TX

Sources for this page

Verify at the official NPI Registry.