Active NPI
Migdonia Montejo, M.D.
- Specialist
- Norfolk, VA
National Provider Identifier
1467459347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0101058505
- Practice address
- 110 Kingsley LN
Suite 106
Norfolk, VA 23505-4614 - Phone
- (757) 889-5735
- Fax
- (757) 889-5742
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0101058505 | VA | Primary |
Addresses
Primary practice location
110 Kingsley LN
Suite 106
Norfolk, VA 23505-4614
Mailing address
110 Kingsley LN
Suite 106
Norfolk, VA 23505-4614
Phone (757) 889-5735
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119124 | Other | VA | ANTHEM BC/BS |
| 7852026 | Other | AETNA | |
| 5602076 | Medicaid | VA | |
| 19462 | Other | VA | SENTARA OPTIMA |
| 370927 | Other | MDIPA/MAMSI/OPTIMUM | |
| 603296 | Other | PA | BC/BS PENNSYLVANIA |
| 89064GW | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080116000376 | VA | Practitioner - Family Practice | 2062593080 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tidewater Medical Care PC
Practice addresses (Care Compare)
Virginia Beach, VA 23451
Phone (757) 965-9465
Hospital & facility affiliations
- Equilibrio Home Health of Virginia Inc
- Amedisys Hospice Care
- Westminster-Canterbury at Home LLC
- Sentara Norfolk General Hospital
- Lake Taylor Transitional Care Hospital
- Lake Taylor Hosp
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tidewater Medical Care PC | Current | Accepting new patients | |
| Integrated Medical Services PLC | Specialist | Past | Accepting new patients |
Locations
109 Wimbledon Sq
Ste G1
Chesapeake, VA 23320
Phone (757) 965-9465
1309 Kempsville Rd
Norfolk, VA 23502
Phone (757) 446-5794
3330 Pacific Ave
Ste 200
Virginia Beach, VA 23451
Phone (757) 965-9465
2101 Parks Ave
Ste 305
Virginia Beach, VA 23451
Phone (757) 749-2308
Organizations & group practices 2
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.
-
- Specialist
- Virginia Beach, VA
- NPI 1770596306
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Chesapeake, VA
- NPI 1447575733
Hospice
-
- Home Health Agency
- Virginia Beach, VA
- NPI 1669852208
-
- Nursing Facility/Intermediate Care Facility
- Virginia Beach, VA
- NPI 1073541645
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197936000000",
"number": "1467459347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 KINGSLEY LN",
"address_2": "SUITE 106",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235054614",
"telephone_number": "757-889-5735",
"fax_number": "757-889-5742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 KINGSLEY LN",
"address_2": "SUITE 106",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235054614",
"telephone_number": "757-889-5735",
"fax_number": "757-889-5742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTEJO",
"first_name": "MIGDONIA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2007-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "0101058505",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "119124",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7852026",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5602076",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA OPTIMA",
"identifier": "19462",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA/MAMSI/OPTIMUM",
"identifier": "370927",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PENNSYLVANIA",
"identifier": "603296",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89064GW",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.