Individual provider Active NPI

Pedro Ernesto Montanez Sr., MD

  • Pediatrics Physician
  • Sebring, FL
National Provider Identifier
1114952819
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME55464 Issued in FL
Practice address
4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone
(407) 975-0412
Fax
(407) 975-0407
NPI assigned
Jul 11, 2006
Last updated
Aug 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME55464 FL Primary
Hospitalist Physician 208M00000X ME55464 FL

Addresses

Primary practice location

4200 Sun N Lake Blvd
Sebring, FL 33872-1986

Mailing address

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (407) 975-0412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160620001698 FL Practitioner - Pediatric MedicinePractitioner - Hospitalist 9133410384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME55464FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

533 Carlton St
Wauchula, FL 33873
Phone (863) 767-8256

Interoperability endpoints

  • Direct secure messaging: pmontanez618037@adventhealth.direct-ci.com

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1114952819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "407-975-0412",
            "fax_number": "407-975-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "407-975-0412",
            "fax_number": "407-975-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANEZ",
        "first_name": "PEDRO",
        "middle_name": "ERNESTO",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME55464",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME55464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.