Individual provider Active NPI

Colette Montoni

  • Nurse Practitioner
  • Gloucester, MA
National Provider Identifier
1336696053
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2263095 Issued in MA
Practice address
1 Blackburn Dr
Gloucester, MA 01930-2237
Phone
(978) 281-1500
NPI assigned
Sep 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG0716105 MA
Nurse Practitioner 363L00000X RN2263095 MA Primary

Addresses

Primary practice location

1 Blackburn Dr
Gloucester, MA 01930-2237

Mailing address

6 Traverse St
Gloucester, MA 01930-3232

Other practice location 1

41 Mall Rd
Burlington, MA 01805-2237
Phone (781) 744-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170224000689 MA Practitioner - Nurse Practitioner 2769766476 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG0716105MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. CurrentSince Dec 8, 2021 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 3, 2025 Accepting new patients
Lahey Clinic, Inc CurrentSince Dec 8, 2021 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 3, 2025 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 3

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": "1473465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1336696053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TRAVERSE ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019303232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACKBURN DR",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019302237",
            "telephone_number": "978-281-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018052237",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTONI",
        "first_name": "COLETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-10",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "AG0716105",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2263095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.