Individual provider Active NPI

Martha Elisa Montero

  • Certified Registered Nurse Anesthetist
  • Orange Park, FL
National Provider Identifier
1386893030
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9218889 Issued in FL
Practice address
1670 Eagle Harbor Pkwy
Orange Park, FL 32003-4820
Phone
(904) 644-0700
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9218889 FL
Certified Registered Nurse Anesthetist 367500000X ARNP9218889 FL Primary

Addresses

Primary practice location

1670 Eagle Harbor Pkwy
Orange Park, FL 32003-4820

Mailing address

1670 Eagle Harbor Pkwy
Orange Park, FL 32003-4820
Phone (904) 644-0700

Other identifiers 2

IdentifierTypeStateIssuer
010390100MedicaidFL
003159802AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140218001598 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123166816 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East West Anesthesia LLCGroup PAC ID 8628449402, 6 clinicians
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

1855 Eastwest Pkwy
Fleming Island, FL 32003-6348
Phone (904) 272-2020

63 Barkley Cir
Suite 103
Fort Myers, FL 33907-4514
Phone (239) 275-8882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 22, 2022 Accepting new patients
East West Anesthesia LLC CurrentSince Dec 1, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 6, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 6, 2014 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 11, 2014 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

1855 Eastwest Pkwy
Fleming Isle, FL 32003

63 Barkley Cir
Ste 103
Fort Myers, FL 33907
Phone (239) 275-8882

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

7051 Southpoint Pkwy S
Jacksonville, FL 32216
Phone (904) 432-1521

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

1670 Eagle Harbor Pkwy
Orange Park, FL 32003

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1386893030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 EAGLE HARBOR PKWY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320034820",
            "telephone_number": "904-644-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 EAGLE HARBOR PKWY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320034820",
            "telephone_number": "904-644-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTERO",
        "first_name": "MARTHA",
        "middle_name": "ELISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9218889",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9218889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010390100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003159802A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.