Lolita Bruch Reyes-Montoya, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17204 Issued in CA

Practice address

73211 Fred Waring Dr
Suite 100
Palm Desert, CA 92260-2871

Phone

(760) 568-4939

Fax

(760) 568-4769

NPI assigned

Jun 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lolita.reyesmontoya.p2@direct.mydohc.nextgenshare.com

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.

• A Gregory Caruso MD Inc

  dba Sunlife Medical Group

  • Family Medicine Physician
  • Palm Desert, CA
  • NPI 1215149745
  Medicare reassignment
• Desert Medical Group, Inc.

  dba Desert Oasis Healthcare Medical Group

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1114918612
  Medicare reassignment
• Inland Physicians Service Inc

  dba Inland Region Medical Group

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1083724850
  Medicare reassignment
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1255535282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73211 FRED WARING DR",
            "address_2": "SUITE 100",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602871",
            "telephone_number": "760-568-4939",
            "fax_number": "760-568-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73211 FRED WARING DR",
            "address_2": "SUITE 100",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602871",
            "telephone_number": "760-568-4939",
            "fax_number": "760-568-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES-MONTOYA",
        "first_name": "LOLITA",
        "middle_name": "BRUCH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2002-0037",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Renke, MD
• Retina Institute of California Medical Group
• Retina Institute of California Medical Group
• Retina Institute of California Medical Group, a California Medical Par (Acuity Optical)
• Jennifer Reyes Rivas
• Carla Reynolds, R.N.
• Julie Sly Reynolds, MFT
• Richard I Torban a Professional Corporation (Desert Psychiatric Associates)
• Richard J. Gill, D.D.S., Inc.
• Cynthia Richardson, R.N., N.P.

• Physician Assistant in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.