Individual provider Active NPI

Heidi S Montague, FNP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1316033103
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN079558 Issued in AZ
Practice address
2990 N Swan Rd
#227
Tucson, AZ 85712-6025
Phone
(520) 664-8624
Fax
(520) 203-8899
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN079558 AZ Primary

Addresses

Primary practice location

2990 N Swan Rd
#227
Tucson, AZ 85712-6025

Mailing address

2675 N Wyatt Dr
#126
Tucson, AZ 85712-6107
Phone (520) 548-3725

Other identifiers 1

IdentifierTypeStateIssuer
390097MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20121022000482 AZ Practitioner - Nurse Practitioner 4486749710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace Medical Group LLCGroup PAC ID 7012306624, 5 clinicians

Practice addresses (Care Compare)

2675 N Wyatt Dr
Tucson, AZ 85712-6107
Phone (520) 260-0937

Hospital & facility affiliations

  • St Joseph'S Hospital Hospital, Tucson, AZ, CCN 030011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Solutions, LLC CurrentSince Sep 1, 2012 Accepting new patients
Grace Medical Group LLC CurrentSince Sep 7, 2021 Accepting new patients
Pathways Medical Partners CurrentSince Jan 1, 2017 Accepting new patients
Catalina Hospice PLLC PastSince Sep 20, 2020 Accepting new patients
NM Pacs 2 LLC Past Accepting new patients
Agape Hospice & Palliative Care, LLC Past Accepting new patients

Locations

2675 N Wyatt Dr
#126
Tucson, AZ 85712

2990 N Swan Rd
Ste 227
Tucson, AZ 85712
Phone (520) 232-9797

4729 E Sunrise Dr
Tucson, AZ 85718
Phone (520) 661-5125

1700 E River Rd
Unit 65177
Tucson, AZ 85728
Phone (520) 635-9103

2675 N Wyatt Dr
Tucson, AZ 85712
Phone (520) 260-0937

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grace Hospice and Palliative Care LLCTucson, AZ, CCN 031775 Hospice 5% Or Greater Direct Ownership Interest (12.5%) Aug 19, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1316033103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 N WYATT DR",
            "address_2": "#126",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126107",
            "telephone_number": "520-548-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 N SWAN RD",
            "address_2": "#227",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126025",
            "telephone_number": "520-664-8624",
            "fax_number": "520-203-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "HEIDI",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN079558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390097",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.