Individual provider Active NPI

Armyda Montoya Novoa, MD

  • Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1255957684
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036164789 Issued in IL
Practice address
2239 E Cook St
Springfield, IL 62703-1944
Phone
(217) 788-2300
Fax
(217) 788-2343
NPI assigned
Jun 22, 2020
Reactivated
Feb 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036164789 IL Primary

Addresses

Primary practice location

2239 E Cook St
Springfield, IL 62703-1944

Mailing address

2239 E Cook St
Springfield, IL 62703-1944
Phone (217) 788-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230720001019 IL Practitioner - Pediatric Medicine 0648630764 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036164789ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Counties Health Centers, Inc. CurrentSince Jul 17, 2023 Accepting new patients
Central Counties Health Centers, Inc. Pediatrics CurrentSince Jul 17, 2023 Accepting new patients

Locations

2239 E Cook St
Springfield, IL 62703

Interoperability endpoints

  • Direct secure messaging: armyda.montoyanovoa@cchci.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1255957684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 E COOK ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627031944",
            "telephone_number": "217-788-2300",
            "fax_number": "718-963-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 E COOK ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627031944",
            "telephone_number": "217-788-2300",
            "fax_number": "217-788-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOYA NOVOA",
        "first_name": "ARMYDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "deactivation_date": "2022-01-17",
        "reactivation_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036164789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.