NPIMap

Individual provider Active NPI

Kacey A Montgomery, MD

  • Pain Medicine (Anesthesiology) Physician
  • Pensacola, FL
National Provider Identifier
1447455977
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME109250 Issued in FL
Practice address
4901 Market Place Rd
Pensacola, FL 32504-8986
Phone
(850) 484-4080
NPI assigned
Jun 15, 2007
Last updated
Oct 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME109250 FL
Pain Medicine (Anesthesiology) Physician 207LP2900X FE60217645 WA
Pain Medicine (Anesthesiology) Physician 207LP2900X ME109250 FL Primary

Addresses

Primary practice location

4901 Market Place Rd
Pensacola, FL 32504-8986

Mailing address

PO Box 11637
Pensacola, FL 32524-1637
Phone (850) 484-4080

Other identifiers 1

IdentifierTypeStateIssuer
003775100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110620000634 FL Practitioner - Pain ManagementPractitioner - Anesthesiology 8123206240 Reassigns benefits to 2 organizations
I20220526002256 AL Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 8123206240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
University of Florida College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Pain Consultants LLCGroup PAC ID 1658516570, 37 clinicians

Practice addresses (Care Compare)

135 Medical Park Dr
Suite 2B
Andalusia, AL 36420-5352
Phone (855) 527-7246

4901 Market Place Rd
Pensacola, FL 32504-8986
Phone (850) 484-4080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME109250FLMDAnesthesiology Physician
FE60217645WAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Pain Consultants LLC CurrentSince May 1, 2016 Accepting new patients
Interventional Therapeutics Institute, LLC CurrentSince Aug 1, 2016 Accepting new patients
Clearway Surgery Center of Panama City, LLC Current Accepting new patients
Clearway Surgery Center of Crestview, LLC Current Accepting new patients
The Surgery Center of the Villages, LLC CurrentSince Apr 30, 2014 Accepting new patients
Gulf Coast Pain Consultants LLC CurrentSince May 1, 2016 Accepting new patients
Gulf Coast Pain Consultants LLC Pain Medicine CurrentSince May 1, 2022 Accepting new patients

Locations

135 Medical Park Dr
Ste 2B
Andalusia, AL 36420
Phone (850) 753-8075

408 Medical Park Dr
Atmore, AL 36502
Phone (251) 368-2550

3810 Highway 90
Pace, FL 32571
Phone (850) 476-9000

4901 Market Place Rd
Pensacola, FL 32504
Phone (850) 439-5425

5102 N Davis Hwy
Pensacola, FL 32503
Phone (850) 484-8800

1040 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-6555

17560 SE 109th Terrace Rd
Summerfield, FL 34491
Phone (352) 347-1112

201 Defense Hwy
Ste 205
Annapolis, MD 21401

Interoperability endpoints

  • Direct secure messaging: kacey.montgomery.1@11679.direct.athenahealth.com
  • Direct secure messaging: kaceymontgomery@gcpi-fl.direct.office.nextgen.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 4

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1447455977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11637",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325241637",
            "telephone_number": "850-484-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 MARKET PLACE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048986",
            "telephone_number": "850-484-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KACEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME109250",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "FE60217645",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME109250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003775100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.