Gary Paul Montague

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0002507 Issued in CO

Practice address

1100 Balsam Avenue
Boulder, CO 80304-3404

Phone

(303) 440-2037

Fax

(303) 306-7753

NPI assigned

Oct 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Gary P. Montague Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Boulder Community Health

  dba Community Medical Associates of BCH

  • Multi-Specialty Clinic/Center
  • Boulder, CO
  • NPI 1609822030
  NPD (past)
• Boulder Community Health

  dba Community Medical Assoc of BCH

  • Primary Care Clinic/Center
  • Boulder, CO
  • NPI 1740837137
  NPD (past)

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1235327974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 173894",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173894",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BALSAM AVENUE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043404",
            "telephone_number": "303-440-2037",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "GARY",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA2507",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0002507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32372736",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "MONTAGUE",
            "middle_name": "P.",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Monarch Physical Therapy, Inc.
• Monique Vincent Counseling, LLC
• James Bradley Monk, D.D.S.
• William Jay Monroe, LCSW
• Lynda J. Monsey, RN, NP, MSN
• Paula Edith Montanez, RHIT
• Alexandru Montano, M.A
• Joseph Robert Montante, M.D.
• Joel R Montbriand, M.D., F.A.C.P.
• Fabiana Monte Alegre Olmos Fernandez, MD

• Physician Assistant in Boulder, CO
• Providers in Boulder, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.