NPIMap

Individual provider Active NPI

Sara Blakely Montoya, MD

  • Family Medicine Physician
  • Summerville, SC
National Provider Identifier
1205893690
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14024 Issued in SC
Practice address
507 N Laurel St
Summerville, SC 29483-6558
Phone
(843) 875-0600
Fax
(843) 871-3499
NPI assigned
Apr 28, 2006
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14024 SC Primary

Addresses

Primary practice location

507 N Laurel St
Summerville, SC 29483-6558

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 572-7727

Other identifiers 2

IdentifierTypeStateIssuer
080092632OtherSCRR MEDICARE
140243MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20031204000604 SC Practitioner - Family Practice 4587569348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

710 Rabon Rd
Suite 203
Columbia, SC 29203-8903
Phone (803) 274-6166

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14024SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC Family Medicine Current Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine CurrentSince Aug 1, 2007 Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine Current Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine CurrentSince Aug 1, 2007 Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

776 Daniel Ellis Dr
Ste 1B
Charleston, SC 29412
Phone (843) 795-0300

710 Rabon Rd
Ste 203
Columbia, SC 29203
Phone (803) 274-6166

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397

300 W 4th North St
Summerville, SC 29483
Phone (843) 285-7515

507 N Laurel St
Summerville, SC 29483
Phone (843) 875-0600

809 N Cedar St
Summerville, SC 29483
Phone (843) 871-9440

Interoperability endpoints

  • Direct secure messaging: sara.montoya@ppcp1.eclinicaldirectplus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1205893690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-572-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N LAUREL ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836558",
            "telephone_number": "843-875-0600",
            "fax_number": "843-871-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "SARA",
        "middle_name": "BLAKELY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "14024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080092632",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140243",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.