Individual provider Active NPI

Juan Jose Montoya Jr.

  • Medical Physician Assistant
  • Maitland, FL
National Provider Identifier
1346771995
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9110697 Issued in FL
Practice address
500 Winderley PL Ste 115
Maitland, FL 32751-7406
Phone
(407) 875-0555
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9110697 FL Primary

Addresses

Primary practice location

500 Winderley PL Ste 115
Maitland, FL 32751-7406

Mailing address

1927 Legacy Cove Dr
Maitland, FL 32751-7524
Phone (407) 242-5560

Other practice location 1

1150 Lake Shadow Cir
Apt 3307
Maitland, FL 32751-7551
Phone (407) 242-5560

Other practice location 2

1150 Lake Shadow Cir
Apt 3307
Maitland, FL 32751-7551
Phone (407) 242-5560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20171025002853 FL Practitioner - Physician Assistant 8527334168 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.2 of 100Reported as group
Quality
78.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110697FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/ Sunbelt, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Urgent Care Centers of Brevard County LLC CurrentSince Aug 1, 2021 Accepting new patients
Urgent Care Centers of Brevard County LLC CurrentSince Aug 1, 2021 Accepting new patients
Adventist Health System/Sunbelt Inc. CurrentSince Aug 1, 2021 Accepting new patients
Dispatchhealth-Florida Inc. PastSince Aug 1, 2021 Accepting new patients
Observation Medicine Specialists LLC PastSince Dec 15, 2019 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

105 S Banana River Blvd
Cocoa Beach, FL 32931
Phone (321) 783-3362

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346771995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 LEGACY COVE DR",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517524",
            "telephone_number": "407-242-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517406",
            "telephone_number": "407-875-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Lake Shadow Cir",
            "address_2": "Apt 3307",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327517551",
            "country_code": "US",
            "telephone_number": "407-242-5560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 Lake Shadow Cir",
            "address_2": "Apt 3307",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327517551",
            "country_code": "US",
            "telephone_number": "407-242-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.