Sandra Rocio Montezuma, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

53409 Issued in MN

Practice address

3525 Plymouth Blvd Ste 207
Plymouth, MN 55447-1384

Phone

(763) 273-8800

Fax

(763) 450-9726

NPI assigned

Dec 21, 2006

Last updated

Jul 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Ophthalmology

Education

Other, 1995

Medicare assignment

May accept Medicare assignment

Group practices

Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

University of Minnesota PhysiciansGroup PAC ID 9830001189, 158 clinicians

University of Minnesota Health Clinics and Surgery Center IncGroup PAC ID 9133423304, 612 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Merit-based Incentive Payment System (MIPS)

Final score

88.63 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Merit-based Incentive Payment System (MIPS)

Final score

92.66 of 100Reported as group

Quality

79.17

Promoting interoperability

100

Improvement activities

40

Cost

73.43

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smontezuma122336@fairview.direct-ci.com

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.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment Care Compare group NPD
• Retina Specialists of Minnesota PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Plymouth, MN
  • NPI 1841135340
  Medicare reassignment NPD Authorized official
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment Care Compare group NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment Care Compare group NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Express Care

  dba Fairview Clinics Specialty

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  dba M Health Fairview Northland Medical Center

  • Hospitalist Physician
  • Princeton, MN
  • NPI 1013097377
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  dba University of Minnesota Health Clinics and Surgery Center - Anesthesia

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Pediatric Dental Clinic

  • Dentist
  • Minneapolis, MN
  • NPI 1992075287
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  dba University of MN Medical Center, Fairview Transitional Care

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1285798470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 PLYMOUTH BLVD STE 207",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471384",
            "telephone_number": "763-273-8800",
            "fax_number": "763-450-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 PLYMOUTH BLVD STE 207",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471384",
            "telephone_number": "763-273-8800",
            "fax_number": "763-450-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEZUMA",
        "first_name": "SANDRA",
        "middle_name": "ROCIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "53409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monarch Behavioral Health PLLC
• Mondale Dental LLC (Roger Mondale, DDS)
• Roger Alan Mondale, D.D S.
• Benjamin Monseth
• Amanda Beth Monson, DNP, APRN, CRNA
• Paul Daeboo Moon, D.C.
• Derryck Vancurk Moore, LADC
• Kelsey Moore, OD
• Leah Moore
• Sara Nikolai Moore

• Ophthalmology Physician in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.