Individual provider Active NPI

Gerald Tariao Montano, D.O.

  • Pediatric Adolescent Medicine Physician
  • Wailuku, HI
National Provider Identifier
1528370558
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
DOS-2343 Issued in HI
Practice address
1881 Nani St
Wailuku, HI 96793-1811
Phone
(808) 871-7772
Fax
(808) 872-4092
NPI assigned
Jul 7, 2010
Last updated
May 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X OS016563 PA
Pediatric Adolescent Medicine Physician 2080A0000X DOS-2343 HI Primary

Addresses

Primary practice location

1881 Nani St
Wailuku, HI 96793-1811

Mailing address

1881 Nani St
Wailuku, HI 96793-1811
Phone (808) 871-7772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20230320001052 HI Practitioner - Pediatric Medicine 6002186749 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS016563PAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Clinic of Maui, Inc. CurrentSince May 1, 2023 Accepting new patients
Community Clinic of Maui, Inc. CurrentSince May 1, 2023 Accepting new patients
Community Clinic of Maui, Inc. Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1881 Nani St
Wailuku, HI 96793
Phone (808) 871-7772

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1528370558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772",
            "fax_number": "808-872-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 NANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931811",
            "telephone_number": "808-871-7772",
            "fax_number": "808-872-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANO",
        "first_name": "GERALD",
        "middle_name": "TARIAO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "OS016563",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "HI",
            "license": "DOS-2343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.