Individual provider Active NPI

Michael Montuno, MD

  • MOHS-Micrographic Surgery Physician
  • Zephyrhills, FL
National Provider Identifier
1164841797
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
ME139918 Issued in FL
Practice address
38135 Market SQ Ste 108
Zephyrhills, FL 33542-7505
Phone
(813) 780-8085
Fax
(813) 355-5042
NPI assigned
Apr 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
MOHS-Micrographic Surgery Physician 207ND0101X ME139918 FL Primary

Addresses

Primary practice location

38135 Market SQ Ste 108
Zephyrhills, FL 33542-7505

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

Other practice location 1

4037 NW 86th Ter
4th Floor
Gainesville, FL 32606-9277
Phone (352) 594-1500

Other practice location 2

17401 Commerce Park Blvd Ste 104
Tampa, FL 33647-3507
Phone (813) 780-8085

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624000909 FL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 1052539889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

2100 Via Bella Blvd
Land O Lakes, FL 34639-5429

38101 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 715-0195

38103 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 778-0414

38105 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 815-5380

38107 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 979-0440

38135 Market Square Dr
Zephyrhills, FL 33542-7505

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision119
Removal of skin lesions38
Removal of skin cancer1404
Skin biopsy20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME139918FLMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic LLC CurrentSince Aug 1, 2019 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Ohi West Medical Group II LLC CurrentSince Apr 1, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Aug 1, 2019 Accepting new patients
Skin Cancer Center Inc Past Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

2100 Via Bella Blvd
Ste 101
Land O Lakes, FL 34639
Phone (813) 948-1498

17401 Commerce Park Blvd
Ste 104
Tampa, FL 33647
Phone (813) 751-0777

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 108
Zephyrhills, FL 33542
Phone (813) 780-8085

38103 Market Square Dr
Zephyrhills, FL 33542
Phone (407) 849-0840

38105 Market Square Dr
Zephyrhills, FL 33542
Phone (321) 841-4449

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1164841797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ STE 108",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-780-8085",
            "fax_number": "813-355-5042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4037 NW 86th Ter",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326069277",
            "country_code": "US",
            "telephone_number": "352-594-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17401 Commerce Park Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336473507",
            "country_code": "US",
            "telephone_number": "813-780-8085",
            "fax_number": "813-355-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTUNO",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME139918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.