Caitlin Laura Montgomery, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A146233 Issued in CA

Practice address

2652 El Camino Real
Santa Clara, CA 95051

Phone

(408) 524-5952

NPI assigned

Apr 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Caitlin Laura Nickols Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1336534775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "650-691-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2652 EL CAMINO REAL",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "95051",
            "telephone_number": "408-524-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CAITLIN",
        "middle_name": "LAURA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A146233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "NICKOLS",
            "middle_name": "LAURA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abigail Rose Paquia Monje, OT
• Sarah Monreal
• Anthony Montalvo
• Sarah Monte, DPT
• Michelle Marie Monterrey
• Jannell Patricia Montoya
• Divya Moodalbail
• Aarian Moogat
• Moon Acupuncture Inc
• Jordan Moore

• Pediatrics Physician in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.