NPIMap

Individual provider Active NPI

Nicholas J Montello, DNP FNP

  • Family Nurse Practitioner
  • Ticonderoga, NY
National Provider Identifier
1184285751
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345137 Issued in NY
Practice address
101 Adirondack Dr Ste 2
Ticonderoga, NY 12883-9334
Phone
(518) 585-6708
Fax
(518) 585-3260
NPI assigned
Jun 25, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 5

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.

Hospital & facility affiliations 26

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

View all 26

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Headwaters Health Network 221 clinicians

Practice addresses (Care Compare)

101 Adirondack Dr
Suite 2
Ticonderoga, NY 12883-9334
Phone (518) 585-6708

24 Fairfield Ave
Schroon Lake, NY 12870-0292
Phone (518) 532-7120

Hospital & facility affiliations

  • HCR / HCR Home Care Chha (Plattsburgh) Home health agency, Plattsburgh, NY, CCN 337024
  • Essex County Nursing Service Home health agency, Elizabethtown, NY, CCN 337118
  • Elizabethtown Community Hospital Hospital, Elizabethtown, NY, CCN 331302
  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191
  • Porter Hospital Inc Hospital, Middlebury, VT, CCN 471307
  • Elderwood at Ticonderoga Nursing home, Ticonderoga, NY, CCN 335482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111001703 NY Practitioner - Nurse Practitioner 0941632020 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
345137NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabethtown Community Hospital CurrentSince Oct 1, 2023 Accepting new patients
Hudson Headwaters Health Network CurrentSince Oct 7, 2019 Accepting new patients
Hudson Headwaters Health Network CurrentSince Oct 7, 2019 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients
1019 Wicker Street Operating Company, LLC Past Accepting new patients

Locations

9 Carey Rd
Queensbury, NY 12804

102 Race Track Rd
#1
Ticonderoga, NY 12883
Phone (518) 585-6708

101 Adirondack Dr
Ste 2
Ticonderoga, NY 12883
Phone (518) 585-6708

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345137 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

101 Adirondack Dr Ste 2
Ticonderoga, NY 12883-9334

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other practice location 1

33 Tom Phelps Lane
Mineville, NY 12956-0480
Phone (518) 942-7123

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
05815090MedicaidNY

Electronic endpoints 2

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address nicholas.montello.1@1823.direct.athenahealth.com
Direct Messaging Address nicholas.montello.1@1823.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 13, 2025.

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1184285751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ADIRONDACK DR STE 2",
            "city": "TICONDEROGA",
            "state": "NY",
            "postal_code": "128839334",
            "telephone_number": "518-585-6708",
            "fax_number": "518-585-3260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Tom Phelps Lane",
            "address_purpose": "LOCATION",
            "city": "Mineville",
            "state": "NY",
            "postal_code": "129560480",
            "country_code": "US",
            "telephone_number": "518-942-7123",
            "fax_number": "518-942-7041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTELLO",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "DNP FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2025-06-13",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05815090",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicholas.montello.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "101 Adirondack Dr Ste 2",
            "city": "Ticonderoga",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128839334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicholas.montello.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "33 Tom Phelps Lane",
            "city": "Mineville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "129560480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ticonderoga, NY

Sources for this page

Verify at the official NPI Registry.