Organization Active NPI

Jesus Montesano MD Medical Center

  • Primary Care Clinic/Center
  • Hialeah, FL
National Provider Identifier
1104636208
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JESUS MONTESANO MD MEDICAL CENTER
Practice address
664 E 25TH St Ste 101
Hialeah, FL 33013-3806
Phone
(645) 229-1317
NPI assigned
Jan 10, 2025
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Jesus Montesano, MDNPI 1295836005
Title
Owner
Phone
(645) 229-1317

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

664 E 25TH St Ste 101
Hialeah, FL 33013-3806

Mailing address

664 E 25TH St Ste 101
Hialeah, FL 33013-3806
Phone (645) 229-1317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250314001689 FL Part B Supplier - Clinic/Group Practice 1456873876 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

664 E 25th St
Ste 101
Hialeah, FL 33013
Phone (305) 835-7625

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1104636208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 E 25TH ST STE 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133806",
            "telephone_number": "645-229-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 E 25TH ST STE 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133806",
            "telephone_number": "645-229-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESUS MONTESANO MD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "MONTESANO",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "645-229-1317",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.