Individual provider Active NPI

Mariyan Montaque, DNP, FNP-BC

  • Family Nurse Practitioner
  • Ashland, MA
National Provider Identifier
1083081046
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2274743 Issued in MA
Practice address
414 Union St
Ashland, MA 01721-2154
Phone
(508) 881-7606
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704289575 MI
Registered Nurse 163W00000X 070619-21 NH
Family Nurse Practitioner 363LF0000X 2274743 MA Primary
Nurse Practitioner 363L00000X RN2274743 MA

Addresses

Primary practice location

414 Union St
Ashland, MA 01721-2154

Mailing address

414 Union St
Ashland, MA 01721-2154
Phone (508) 881-7606

Other practice location 1

242 Green St
Gardner, MA 01440-1373
Phone (978) 630-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20151217001450 MA Practitioner - Nurse Practitioner 1850692708 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

250 Green St
Gardner, MA 01440-1396
Phone (978) 630-6460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704289575MIMDRegistered Nurse
070619-21NHMDRegistered Nurse
2274743MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heywood Medical Group Inc. Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
Henry Heywood Memorial Hospital Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Mar 1, 2022 Accepting new patients
Athol Memorial Hospital Incorporated Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Mar 4, 2019 Accepting new patients
Umass Memorial Medical Group Inc Family Medicine CurrentSince Mar 4, 2019 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

151 Worcester Rd
Barre, MA 01005
Phone (978) 355-6321

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

242 Green St
Ste 205
Gardner, MA 01440

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

55 Lake Ave N
Ofc
Worcester, MA 01655

Interoperability endpoints

  • Direct secure messaging: mariyan.montaque.1@192.direct.athenahealth.com

Organizations & group practices 6

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 4

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1083081046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 UNION ST",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017212154",
            "telephone_number": "508-881-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 UNION ST",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017212154",
            "telephone_number": "508-881-7606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 Green St",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "MA",
            "postal_code": "014401373",
            "country_code": "US",
            "telephone_number": "978-630-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTAQUE",
        "first_name": "MARIYAN",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704289575",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "070619-21",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2274743",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2274743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, MA

Sources for this page

Verify at the official NPI Registry.