Individual provider Active NPI

Lorie A. Montag, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Des Moines, IA
National Provider Identifier
1114953205
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
102401 Issued in MO
Practice address
1212 Pleasant
Suite #LL3
Des Moines, IA 50309-1414
Phone
(515) 241-8861
Fax
(515) 241-8855
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 102401 MO Primary

Addresses

Primary practice location

1212 Pleasant
Suite #LL3
Des Moines, IA 50309-1414

Mailing address

PO Box 744327
Atlanta, GA 30374-4327
Phone (515) 241-8861

Other identifiers 4

IdentifierTypeStateIssuer
10001057500OtherCOMMUNITY HEALTH PLAN
25321019OtherBLUE CROSS BLUE SHIELD KC
100324250AMedicaidKS
203860804MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20090522000475 MO Practitioner - Pathology 6204885262 Reassigns benefits to 1 organization
I20210811002829 KS Practitioner - Pathology 6204885262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Missouri, Columbia School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Irl Pathology Services Midamerica LLCGroup PAC ID 0840558664, 14 clinicians

Practice addresses (Care Compare)

2316 E Meyer Blvd
Kansas City, MO 64132-1136
Phone (816) 276-4593

Hospital & facility affiliations

  • Menorah Medical Center Hospital, Overland Park, KS, CCN 170182
  • Lee'S Summit Medical Center Hospital, Lees Summit, MO, CCN 260190

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102401MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Irl Pathology Services Midamerica, LLC Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2021 Accepting new patients
Northwest Missouri Pathologists, M.D., P.C. Anatomic Pathology & Clinical Pathology PastSince Jan 17, 2005 Accepting new patients

Locations

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

1500 State St
Lexington, MO 64067
Phone (660) 259-2203

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1114953205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744327",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744327",
            "telephone_number": "515-241-8861",
            "fax_number": "515-241-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT",
            "address_2": "SUITE #LL3",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091414",
            "telephone_number": "515-241-8861",
            "fax_number": "515-241-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAG",
        "first_name": "LORIE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "102401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH PLAN",
            "identifier": "10001057500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KC",
            "identifier": "25321019",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100324250A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203860804",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.