Individual provider Active NPI

Lester Stephen Montesa, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1144819285
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008129 Issued in IL
Practice address
180 N Michigan Ave Ste 1605
Chicago, IL 60601-7478
Phone
(312) 201-1234
NPI assigned
Jan 13, 2021
Last updated
Jan 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008129 IL Primary

Addresses

Primary practice location

180 N Michigan Ave Ste 1605
Chicago, IL 60601-7478

Mailing address

2220 W Maypole Ave Unit 302
Chicago, IL 60612-2342
Phone (510) 340-6594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211003305 IL Practitioner - Physician Assistant 6305251901 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008129ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Avenue ENT P.C. Current Accepting new patients

Organizations & group practices 3

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1144819285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 W MAYPOLE AVE UNIT 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122342",
            "telephone_number": "510-340-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE STE 1605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017478",
            "telephone_number": "312-201-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTESA",
        "first_name": "LESTER STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.