Individual provider Active NPI

Joseph Samuel Montgomery III, MD

  • Obstetrics & Gynecology Physician
  • Cypress, TX
National Provider Identifier
1144217001
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
E8740 Issued in TX
Practice address
21212 Northwest Fwy
Suite 315
Cypress, TX 77429-5884
Phone
(281) 955-5300
Fax
(281) 955-8166
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X E8740 TX Primary

Addresses

Primary practice location

21212 Northwest Fwy
Suite 315
Cypress, TX 77429-5884

Mailing address

21212 Northwest Fwy
Suite 315
Cypress, TX 77429-5884
Phone (281) 955-5300

Other identifiers 2

IdentifierTypeStateIssuer
035682601MedicaidTX
OORB05OtherTXP-TAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050114000231 TX Practitioner - Obstetrics/Gynecology 1355390568 Practice locations: Cypress, TX

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Health System Past Accepting new patients

Organizations & group practices 1

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1144217001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21212 NORTHWEST FWY",
            "address_2": "SUITE 315",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295884",
            "telephone_number": "281-955-5300",
            "fax_number": "281-955-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21212 NORTHWEST FWY",
            "address_2": "SUITE 315",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295884",
            "telephone_number": "281-955-5300",
            "fax_number": "281-955-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JOSEPH",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "E8740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035682601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P-TAN",
            "identifier": "OORB05",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.