Individual provider Active NPI

Thomas W Montag, MD

  • Gynecologic Oncology Physician
  • Chesapeake, VA
National Provider Identifier
1306848270
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
0101059160 Issued in VA
Practice address
109 Wimbledon SQ
Suite F
Chesapeake, VA 23320-4945
Phone
(757) 436-9898
Fax
(757) 436-5455
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 0101059160 VA Primary

Addresses

Primary practice location

109 Wimbledon SQ
Suite F
Chesapeake, VA 23320-4945

Mailing address

109 Wimbledon SQ
Suite F
Chesapeake, VA 23320-4945
Phone (757) 436-9898

Other identifiers 11

IdentifierTypeStateIssuer
1075087OtherMAMSI (GYN)
00X210T01OtherVAMEDICARE
1231740OtherFIRST HEALTH
21941OtherSENTARA
3600719OtherUNITED HEALTHCARE
463796OtherANTHEM
1175087OtherMAMSI (ONC)
2998639OtherCIGNA
4232842OtherAETNA
621780-0MedicaidVA
P00065884OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20051021000198 VA Practitioner - Gynecological Oncology 8123044864

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101059160VAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Oncology Associates PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1306848270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WIMBLEDON SQ",
            "address_2": "SUITE F",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204945",
            "telephone_number": "757-436-9898",
            "fax_number": "757-436-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WIMBLEDON SQ",
            "address_2": "SUITE F",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204945",
            "telephone_number": "757-436-9898",
            "fax_number": "757-436-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAG",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "VA",
            "license": "0101059160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI (GYN)",
            "identifier": "1075087",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00X210T01",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1231740",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "21941",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3600719",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "463796",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI (ONC)",
            "identifier": "1175087",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2998639",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4232842",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621780-0",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00065884",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.