Active NPI
Krystalyna Montano
- Physician Assistant
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA55757
- Practice address
- 450 N Graham St
Portland, OR 97227-1682 - Phone
- (503) 413-4488
- NPI assigned
- Jul 26, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA55757 | CA | |
| Physician Assistant | 363A00000X | PA55757 | CA | Primary |
Addresses
Primary practice location
450 N Graham St
Portland, OR 97227-1682
Mailing address
791 1/2 El Centro Rd
El Sobrante, CA 94803-1705
Phone (510) 374-9802
Other practice location 1
1526 Atwood Ave Ste 200
Johnston, RI 02919-3289
Phone (401) 404-2975
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, OR, RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711
1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988
1524 Atwood Ave
Suite 44
Johnston, RI 02919-3228
Phone (401) 272-9880
1681 Cranston St
Cranston, RI 02920-5000
Phone (401) 944-6889
2222 NW Lovejoy St
Suite 411
Portland, OR 97210-5102
Phone (503) 413-5702
450 N Graham St
Portland, OR 97227-1682
Phone (503) 413-4488
Hospital & facility affiliations
- Legacy Good Samaritan Medical Center
- Legacy Emanuel Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA55757 | CA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Joaquin | Current | Accepting new patients | |
| Legacy Clinics LLC | Current | Accepting new patients | |
| County of San Joaquin | Current | Accepting new patients |
Locations
500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
450 N Graham St
Portland, OR 97227
Phone (503) 413-4161
Interoperability endpoints
- krystalyna.montano.1@9000.direct.athenahealth.com
- kmontano811820@direct.lhs.org
Organizations & group practices 5
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.
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
-
- Internal Medicine Physician
- Cranston, RI
- NPI 1629493135
-
- General Acute Care Hospital
- French Camp, CA
- NPI 1801830583
-
- Internal Medicine Physician
- Cranston, RI
- NPI 1235945650
-
- Multi-Specialty Clinic/Center
- Manteca, CA
- NPI 1417407636
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- Clinic/Center
- Portland, OR
- NPI 1679597108
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774224000000",
"number": "1477030989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "791 1/2 EL CENTRO RD",
"city": "EL SOBRANTE",
"state": "CA",
"postal_code": "948031705",
"telephone_number": "510-374-9802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 N GRAHAM ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271682",
"telephone_number": "503-413-4488"
}
],
"practiceLocations": [
{
"address_1": "1526 Atwood Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Johnston",
"state": "RI",
"postal_code": "029193289",
"country_code": "US",
"telephone_number": "401-404-2975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTANO",
"first_name": "KRYSTALYNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-26",
"last_updated": "2026-03-23",
"certification_date": "2026-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "PA55757",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA55757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.