Individual provider Active NPI

Monty A Hawkins, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Prescott, AZ
National Provider Identifier
1508121526
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
57042 Issued in AZ
Practice address
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone
(480) 985-1093
Fax
(480) 296-7665
NPI assigned
Jul 5, 2012
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R73586 AZ
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 57042 AZ Primary

Addresses

Primary practice location

1003 Willow Creek Rd
Prescott, AZ 86301-1641

Mailing address

PO Box 20490
Mesa, AZ 85277-0490
Phone (480) 985-1093

Other practice location 1

2400 S Avenue A
Yuma, AZ 85364-7127
Phone (928) 344-2000

Other identifiers 1

IdentifierTypeStateIssuer
R73586OtherAZTRAINING PERMIT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181012001918 AZ Practitioner - Pathology 1759636251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yavapai Pathology Associates PLCGroup PAC ID 3274426192, 4 clinicians

Practice addresses (Care Compare)

1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone (928) 771-5774

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17971NVMDPharmacist
R73586AZMDAnatomic Pathology & Clinical Pathology Physician
57042AZMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Pathology Associates PLC Clinical Pathology CurrentSince Jul 1, 2023 Accepting new patients
Laboratory Medicine Consultants LTD CurrentSince Aug 21, 2018 Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

1003 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-2700

File 749203
Los Angeles, CA 90074

3059 S Maryland Pkwy
Ste 100
Las Vegas, NV 89109
Phone (702) 732-3441

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

7455 W Washington Ave
Ste 301
Las Vegas, NV 89128
Phone (702) 732-3441

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1508121526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20490",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852770490",
            "telephone_number": "480-985-1093",
            "fax_number": "480-296-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011641",
            "telephone_number": "480-985-1093",
            "fax_number": "480-296-7665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S Avenue A",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853647127",
            "country_code": "US",
            "telephone_number": "928-344-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "MONTY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-05",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "R73586",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "AZ",
            "license": "57042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R73586",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.