Individual provider Active NPI

Lauren Ashley Montgomery, PA-C

  • Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1194615252
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
66614 Issued in CA
Practice address
1001 Harvey Dr Apt 336
Walnut Creek, CA 94597-3606
Phone
(707) 372-1956
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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 66614 CA Primary

Addresses

Primary practice location

1001 Harvey Dr Apt 336
Walnut Creek, CA 94597-3606

Mailing address

1001 Harvey Dr Apt 336
Walnut Creek, CA 94597-3606
Phone (707) 372-1956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250829004425 CA Practitioner - Physician Assistant 2163923137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2637 Shadelands Dr
Walnut Creek, CA 94598-2512

Hospital & facility affiliations

  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66614CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Surgical Specialists Inc a Medical Corporation CurrentSince Sep 2, 2025 Accepting new patients
Bass Medical Group CurrentSince Sep 2, 2025 Accepting new patients
Bass Medical Group Past Accepting new patients
Bass Medical Group Past Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

4626 Willow Rd
Ste 200
Pleasanton, CA 94588
Phone (925) 463-0470

5601 Norris Canyon Rd
Ste 130
San Ramon, CA 94583
Phone (925) 463-0470

2180 W Grant Line Rd
Ste 100
Tracy, CA 95377
Phone (925) 463-0470

2637 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 627-3424

Interoperability endpoints

  • Direct secure messaging: lauren.montgomery.1@25176.direct.athenahealth.com

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1194615252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 HARVEY DR APT 336",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973606",
            "telephone_number": "707-372-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HARVEY DR APT 336",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973606",
            "telephone_number": "707-372-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "LAUREN",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "66614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.