Individual provider Active NPI

Stefanie Tamara Montalvo, FNP-BC

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1235767732
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1140666 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone
(713) 792-6161
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1140666 TX Primary
Oncology Registered Nurse 163WX0200X 990961 TX
Primary Care Nurse Practitioner 363LP2300X 1140666 TX

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4000

Mailing address

PO Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240202001501 TX Practitioner - Nurse Practitioner 8426401704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-2121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
990961TXMDOncology Registered Nurse
1140666TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince Dec 12, 2023 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

Organizations & group practices 1

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1235767732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304000",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALVO",
        "first_name": "STEFANIE",
        "middle_name": "TAMARA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1140666",
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "TX",
            "license": "990961",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1140666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.