Individual provider Active NPI

Connie D Montes, PAC PHYSICIAN ASSIST

  • Physician Assistant
  • Whittier, CA
National Provider Identifier
1265656854
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13711 Issued in CA
Practice address
14609 E Whittier Blvd
Whittier, CA 90605
Phone
(562) 789-9592
Fax
(562) 789-6102
NPI assigned
Apr 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13711 CA Primary

Addresses

Primary practice location

14609 E Whittier Blvd
Whittier, CA 90605

Mailing address

14609 E Whittier Blvd
Whittier, CA 90605
Phone (562) 789-9592

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160721001415 CA Practitioner - Physician Assistant 5799095097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA13711CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince Apr 1, 2020 Accepting new patients
Pih Health Physicians CurrentSince Apr 1, 2020 Accepting new patients

Locations

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

Interoperability endpoints

  • Direct secure messaging: connie.montes.1@24997.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265656854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14609 E WHITTIER BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "90605",
            "telephone_number": "562-789-9592",
            "fax_number": "562-789-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14609 E WHITTIER BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "90605",
            "telephone_number": "562-789-9592",
            "fax_number": "562-789-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES",
        "first_name": "CONNIE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PAC PHYSICIAN ASSIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.