Individual provider Active NPI

Madeleine Montuna

  • Pharmacist
  • Watertown, MA
National Provider Identifier
1336743541
Registry record updated Nov 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH239478 Issued in MA
Practice address
550 Arsenal St
Watertown, MA 02472-2853
Phone
(617) 924-5987
NPI assigned
Nov 28, 2020
Last updated
Nov 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH239478 MA Primary

Addresses

Primary practice location

550 Arsenal St
Watertown, MA 02472-2853

Mailing address

67 Central Ave
Medford, MA 02155-4005
Phone (781) 475-6579

Other identifiers 1

IdentifierTypeStateIssuer
PH239578OtherMAPHARM.D LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH239478MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606521600000",
    "number": "1336743541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 CENTRAL AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554005",
            "telephone_number": "781-475-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722853",
            "telephone_number": "617-924-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTUNA",
        "first_name": "MADELEINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-28",
        "last_updated": "2020-11-28",
        "certification_date": "2020-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH239478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARM.D LICENSE",
            "identifier": "PH239578",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.