Individual provider Active NPI

Connor Mech Montgomery

  • Emergency Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1093392839
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME167544 Issued in FL
Practice address
636 Del Prado Blvd S
Cape Coral, FL 33990-2695
Phone
(239) 424-3513
Fax
(239) 424-4039
NPI assigned
Mar 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME167544 FL Primary

Addresses

Primary practice location

636 Del Prado Blvd S
Cape Coral, FL 33990-2695

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-3513

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmontgomery404332@Direct.leememorial.org Direct Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 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
I20230920002808 NC Practitioner - Emergency Medicine 4587066147
I20240723004314 FL Practitioner - Emergency Medicine 4587066147 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Florida Atlantic University, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Coral Emergency Physicians LLCGroup PAC ID 1557465325, 11 clinicians

Practice addresses (Care Compare)

636 Del Prado Blvd S
Emergency Dept
Cape Coral, FL 33990-2668
Phone (239) 424-2000

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME167544FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Jan 25, 2025 Accepting new patients
Cape Coral Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Jan 25, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Aug 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Aug 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: cmontgomery404332@direct.leememorial.org

Organizations & group practices 5

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 1

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1093392839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-3513",
            "fax_number": "239-424-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902695",
            "telephone_number": "239-424-3513",
            "fax_number": "239-424-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CONNOR",
        "middle_name": "MECH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME167544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmontgomery404332@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.