Kaitlyn Blaire Montgomery, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

014224-1 Issued in NY

Practice address

374 Stockholm St
Brooklyn, NY 11237-4006

Phone

(718) 963-7272

NPI assigned

Jan 4, 2011

Last updated

Sep 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 6103251491, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai Hospital Hospital, New York, NY, CCN 330024

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Now

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1679083984
  Medicare reassignment Care Compare group
• Fpa Hospital Based

  • Nuclear Medicine Physician
  • New York, NY
  • NPI 1629319413
  Medicare reassignment
• Icahn School of Medicine at Mount Sinai

  dba FPA Urgent Care Center

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1124392238
  Medicare reassignment
• Icahn School of Medicine at Mount Sinai

  dba Rehabilitation Fluoroscopy Medicine Department of Mount Sinai

  • Rehabilitation Practitioner
  • New York, NY
  • NPI 1477899078
  Medicare reassignment
• Fpa Hospital Based

  dba FPA Hospital Based MSMC Emergency Physicians

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1427398676
  NPD
• Fpa Hospital Based

  dba Mount Sinai Dermatopathology Services III

  • Dermatopathology (Pathology) Physician
  • New York, NY
  • NPI 1841531795
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Emergency Medical Associates

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1346908662
  NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Eos Medical Group PC

  • Emergency Medicine Physician
  • Carmel, NY
  • NPI 1730119926
  NPD (past)
• Icahn School of Medicine at Mount Sinai

  dba Medicine Department of Mount Sinai

  • Infectious Disease Physician
  • New York, NY
  • NPI 1659639524
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Sinai Hospital

  • Clinical Medical Laboratory
  • New York, NY
  • NPI 1033206362

  Hospital

  Care Compare affiliation
• Mount Sinai Hospital

  • General Acute Care Hospital
  • Long Island City, NY
  • NPI 1245248939
  Care Compare affiliation
• Mount Sinai Hospital

  • Rehabilitation Hospital
  • New York, NY
  • NPI 1669440327
  Care Compare affiliation
• Mount Sinai Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1932103413
  Care Compare affiliation
• Mount Sinai Hospital Pharmacy

  • General Acute Care Hospital
  • New York, NY
  • NPI 1225295512
  Care Compare affiliation
• Mount Sinai Hospital-Ambulance

  • Ambulance
  • New York, NY
  • NPI 1568601342

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1538463682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 4TH AVE",
            "address_2": "APT 1L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172739",
            "telephone_number": "845-742-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "288 Flatbush Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112172812",
            "country_code": "US",
            "telephone_number": "718-656-1290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KAITLYN",
        "middle_name": "BLAIRE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014224-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Montesinos
• Montessori Playhouse
• Brian Montevirgen, M.D.
• Cheresse Paige Montford, MD
• Antonio Wesley Montgomery, M.D.
• Kalli S Monti, AUD
• Regina Monti, PSY.D.
• Isabella Monticciolo
• Estefani Montiel
• Francesca Montijo

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.

Verify at the official NPI Registry.