Active NPI
Oliver Jose Manuel Montiel Paez, SA-C
- Surgical Assistant
- Indianapolis, IN
National Provider Identifier
1568032795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 21-390
- Practice address
- 8579 Whipporwill Dr Apt C
Indianapolis, IN 46256-3660 - Phone
- (434) 421-5403
- NPI assigned
- Jun 29, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 21-390 | FL | Primary |
Addresses
Primary practice location
8579 Whipporwill Dr Apt C
Indianapolis, IN 46256-3660
Mailing address
8579 Whipporwill Dr Apt C
Indianapolis, IN 46256-3660
Phone (434) 421-5403
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21-390 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1568032795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8579 WHIPPORWILL DR APT C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462563660",
"telephone_number": "434-421-5403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8579 WHIPPORWILL DR APT C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462563660",
"telephone_number": "434-421-5403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTIEL PAEZ",
"first_name": "OLIVER JOSE MANUEL",
"credential": "SA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "21-390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.