Paul Montgomery, MD

Primary specialty

Pediatric Radiology PhysicianTaxonomy code 2085P0229X

License

036-148104 Issued in IL

Practice address

4440 W 95TH St Dept of
Oak Lawn, IL 60453-2600

Phone

(708) 684-5503

Fax

(708) 684-2675

NPI assigned

Dec 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pmontgomery253997@direct.myadvocateaurora.org

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.

• University Radiology at Buffalo, Inc.

  • Diagnostic Radiology Physician
  • Buffalo, NY
  • NPI 1750744751
  NPD (past)
• Wny Petct LLC

  • Diagnostic Radiology Physician
  • Buffalo, NY
  • NPI 1770632226
  NPD (past)

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670630400000",
    "number": "1093799157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST DEPT OF",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5503",
            "fax_number": "708-684-2675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 College Pkwy",
            "address_2": "Suite 180",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "142216800",
            "country_code": "US",
            "telephone_number": "716-636-1902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2022-12-10",
        "certification_date": "2022-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NY",
            "license": "152482",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IL",
            "license": "036-148104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "1609168",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF WESTERN NY",
            "identifier": "000510109013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00025517704",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "1524826CR",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmontgomery253997@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4440 W 95th St Dept Of",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4440 W 95th St Dept Of",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alyssa M Monsivais, APN-CNM
• Margaret V Montejano
• Marcus Montes
• Brianne Montesdeoca
• Malika Montgomery
• Travis Montgomery, RNFA
• Beatriz Montoya
• Sheri Moonan, CNS, APN
• Amy M Moore
• Cierra Moore

• Pediatric Radiology Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Pediatric Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.