Tywanna Jaye Montgomery

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

11022335 Issued in FL

Practice address

801 W Bay Dr Ste 605
Largo, FL 33770-3268

Phone

(727) 489-3305

NPI assigned

Oct 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Value Based Long Term Care F PCGroup PAC ID 2769922731, 18 clinicians

Legacy Health Medical Group, LLCGroup PAC ID 5193962173, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hygeia Home Health LLC Home health agency, Largo, FL, CCN 108461
• Keystone Home Health Inc Home health agency, St Petersburg, FL, CCN 108469
• Instruments for Hope LLC Home health agency, Largo, FL, CCN 687127
• Enhabit Home Health Home health agency, Clearwater, FL, CCN 109687
• Pinellas 1 Home Health Care Corp Home health agency, Clearwater, FL, CCN 683182

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Value Based Long Term Care F PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Largo, FL
  • NPI 1831921360

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Legacy Health Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Largo, FL
  • NPI 1881942779
  Medicare reassignment Care Compare group
• Careconnectmd Florida P.a.

  • Geriatric Medicine (Internal Medicine) Physician
  • Jacksonville, FL
  • NPI 1912632886

  Multi-Specialty

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Avery Tritt Holdings, LLC

  dba Hygeia Home Health

  • Home Health Agency
  • Clearwater, FL
  • NPI 1528455854
  Care Compare affiliation
• Eh Home Health of the Southeast, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Clearwater, FL
  • NPI 1134535545
  Care Compare affiliation
• Instruments for Hope LLC

  • Home Health Agency
  • Largo, FL
  • NPI 1417417940
  Care Compare affiliation
• Keystone Home Health, Inc.

  • Home Health Agency
  • St Petersburg, FL
  • NPI 1609976950
  Care Compare affiliation
• Pinellas 1 Home Health Care Corp

  • Home Health Agency
  • Clearwater, FL
  • NPI 1861803850
  Care Compare affiliation

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1164147187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9435 TEMPLE AVE",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337723033",
            "telephone_number": "813-810-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W BAY DR STE 605",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703268",
            "telephone_number": "727-489-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "TYWANNA",
        "middle_name": "JAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "11022335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moneer M. Mansour,MD.PA
• Ally Monheim, OTR/L
• Renee Lokenberg Montaudo, AUD
• Manuel David Montes, DPM
• Nancy Montgomery, D.M.D
• Yeny Monzon
• Summer Moon, DO
• Allison Moore, D.O.
• Mikaella Moore, PT, DPT
• Steven M Moore, M.D.

• Adult Medicine Physician in Largo, FL
• Providers in Largo, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.