Blaine K Montague, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9508541-1206 Issued in UT

Practice address

819 E Marketplace Drive
Spanish Fork, UT 84660-2060

Phone

(801) 717-0341

NPI assigned

Sep 16, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Physician Assistant

Education

Duke University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Payson, UT, CCN 460013
• Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  • Dental Clinic/Center
  • Riverton, UT
  • NPI 1073177648
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Spanish Fork, UT
  • NPI 1124661384
  Care Compare affiliation
• Mountain View Hospital, Inc.

  • General Acute Care Hospital
  • Payson, UT
  • NPI 1487607669
  Care Compare affiliation

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1366811606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 E MARKETPLACE DRIVE",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602060",
            "telephone_number": "801-717-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 E MARKETPLACE DRIVE",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602060",
            "telephone_number": "801-717-0341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 N 500 W Ste 121",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043305",
            "country_code": "US",
            "telephone_number": "801-373-7350",
            "fax_number": "801-812-5401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N 500 W Ste 121",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043305",
            "country_code": "US",
            "telephone_number": "801-373-7350",
            "fax_number": "801-812-5401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "BLAINE",
        "middle_name": "K",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9508541-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blaine.montague@direct.imail.org",
            "affiliation": "N",
            "address_1": "819 E Marketplace Drive",
            "city": "Spanish Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846602060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madeline Kae Molen, MSW
• Justyce Molina
• Momentum Health for Women
• Melanie Michelle Monday
• Kimberly Monson
• Jason Keith Morris, M.D.
• Megan Marie Morris
• Targhee James Morris, M.D.
• Jaylene Dalley Mortensen, RD
• Sydney Dawn Mortensen

• Physician Assistant in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.