NPIMap

Individual provider Active NPI

Ramiro A Montalvo Jr., M.D.

  • Internal Medicine Physician
  • Brookhaven, MS
National Provider Identifier
1225147135
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11392 Issued in MS
Practice address
940 Brookway Blvd
Brookhaven, MS 39601-2644
Phone
(601) 823-5000
Fax
(601) 823-4140
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11392 MS Primary

Addresses

Primary practice location

940 Brookway Blvd
Brookhaven, MS 39601-2644

Mailing address

940 Brookway Blvd
Brookhaven, MS 39601-2644
Phone (601) 823-5000

Other identifiers 1

IdentifierTypeStateIssuer
00110853MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20100826000599 MS Practitioner - Internal Medicine 5991848491 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Daughters Medical CenterGroup PAC ID 3072575539, 75 clinicians
KDMC Physician Clinics LLCGroup PAC ID 7012154495, 31 clinicians

Practice addresses (Care Compare)

427 Hwy 51 N
Brookhaven, MS 39601-2350
Phone (601) 833-6011

940 Brookway Blvd
Brookhaven, MS 39601-2644
Phone (601) 823-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11392MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King'S Daughters Medical Center CurrentSince May 6, 2012 Accepting new patients
KDMC Physician Clinics LLC CurrentSince Apr 1, 2013 Accepting new patients
Kings Daughters Medical Center Current Accepting new patients
King'S Daughters Medical Center CurrentSince May 6, 2012 Accepting new patients

Locations

950 Brookway Blvd
Brookhaven, MS 39601
Phone (601) 833-7973

427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011

940 Brookway Blvd
Brookhaven, MS 39601
Phone (601) 823-5000

527 Silver Cross Dr
Brookhaven, MS 39601
Phone (601) 833-2222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6393/brand/1/csg/41/fhir/r4

Organizations & group practices 4

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 10

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1225147135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BROOKWAY BLVD",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012644",
            "telephone_number": "601-823-5000",
            "fax_number": "601-823-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BROOKWAY BLVD",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012644",
            "telephone_number": "601-823-5000",
            "fax_number": "601-823-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALVO",
        "first_name": "RAMIRO",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "11392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00110853",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

Verify at the official NPI Registry.