Individual provider Active NPI

Marco Montenegro

  • Non-emergency Medical Transport (VAN)
  • Las Vegas, NV
National Provider Identifier
1124770870
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
608-T28 Issued in NV
Practice address
2455 W Serene Ave Apt 202
Las Vegas, NV 89123-6559
Phone
(702) 515-9523
NPI assigned
Jan 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 608-T28 NV Primary

Addresses

Primary practice location

2455 W Serene Ave Apt 202
Las Vegas, NV 89123-6559

Mailing address

2455 W Serene Ave Apt 202
Las Vegas, NV 89123-6559
Phone (702) 515-9523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
608-T28NVMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1124770870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 W SERENE AVE APT 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236559",
            "telephone_number": "702-515-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 W SERENE AVE APT 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236559",
            "telephone_number": "702-515-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENEGRO",
        "first_name": "MARCO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NV",
            "license": "608-T28",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.