Jennifer A Montgomery, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

19881 Issued in CA

Practice address

277 Rancheros Dr Ste 100
San Marcos, CA 92069-2959

Phone

(760) 291-6700

Fax

(760) 471-0513

NPI assigned

Sep 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer A Atkinson Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Graybill Medical Group Inc

  • Family Medicine Physician
  • Escondido, CA
  • NPI 1891729745
  Medicare reassignment
• Southbay Urgent Care Inc

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1558746750
  Medicare reassignment
• Dr Carneiro Wound Medicine Corp

  • Primary Care Clinic/Center
  • San Diego, CA
  • NPI 1942983473
  NPD (past)
• Grossmont Emergency Medical Group

  • Emergency Medicine Physician
  • La Mesa, CA
  • NPI 1861437501
  NPD (past)
• Center for Physical Medicine & Rehabilitation P C

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1306959218
  NPD (past)
• Med 97 LLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1487631883
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1568658698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E 2ND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254249",
            "telephone_number": "760-291-6700",
            "fax_number": "760-737-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 RANCHEROS DR STE 100",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692959",
            "telephone_number": "760-291-6700",
            "fax_number": "760-471-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "19881",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ATKINSON",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyssa Y Montejano
• Karin Del Rocio Montemayor, RN
• Manuel Montemayor, MD
• Bella Gloria Montgomery, N.P.
• Ellen Montgomery, D.M.D.
• Elizabeth Montiel, PPS
• Stacy Montiel
• Patricia Jean Mooney, NURSE PRACTITIONER
• Ashley Moore
• Breanna Lynn Kimble Moore, PT, DPT

• Physician Assistant in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.