Individual provider Active NPI

Andres Antonio Montenegro, PA-C

  • Surgical Physician Assistant
  • Coral Gables, FL
National Provider Identifier
1578065900
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9111085 Issued in FL
Practice address
1150 Campo Sano Ave
Coral Gables, FL 33146-1174
Phone
(786) 268-6200
NPI assigned
Mar 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9111085 FL Primary

Addresses

Primary practice location

1150 Campo Sano Ave
Coral Gables, FL 33146-1174

Mailing address

PO Box 100905
Atlanta, GA 30384-0905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20181108001488 FL Practitioner - Physician Assistant 8224382361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group Orthopedics, LLCGroup PAC ID 9335228899, 69 clinicians

Practice addresses (Care Compare)

1150 Campo Sano Ave
Coral Gables, FL 33146-1174
Phone (786) 268-6200

1228 S Pine Island Rd
Suite 310
Plantation, FL 33324-4402
Phone (954) 392-1725

5000 University Dr
Coral Gables, FL 33146-2008
Phone (786) 308-3401

6200 SW 73 St
South Miami, FL 33143-4679
Phone (786) 662-4000

Hospital & facility affiliations

  • Doctors Hospital Hospital, Coral Gables, FL, CCN 100296
  • South Miami Hospital Hospital, Miami, FL, CCN 100154

Merit-based Incentive Payment System (MIPS)

Final score
83.58 of 100Reported as group
Quality
72.08
Promoting interoperability
99
Improvement activities
40
Cost
74.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111085FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Orthopedics, LLC CurrentSince May 26, 2020 Accepting new patients
Baptist Health Medical Group Orthopedics, LLC CurrentSince May 26, 2020 Accepting new patients
Davie Urgent Care LLC Past Accepting new patients
Baptist Health Medical Group Physicians LLC Past Accepting new patients

Locations

1150 Campo Sano Ave
Fl 1
Coral Gables, FL 33146
Phone (502) 852-8905

1150 Campo Sano Ave
Miami, FL 33146
Phone (305) 348-9414

19955 NW 27th Ave
Ste 200
Miami Gardens, FL 33056
Phone (786) 595-1310

13101 S Dixie Hwy
Ste 400
Pinecrest, FL 33156
Phone (786) 467-5700

1228 S Pine Island Rd
Ste 310
Plantation, FL 33324
Phone (954) 392-1725

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

Interoperability endpoints

  • Direct secure messaging: and02379@cerner.directbaptisthealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1578065900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100905",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 CAMPO SANO AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461174",
            "telephone_number": "786-268-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENEGRO",
        "first_name": "ANDRES",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-01",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9111085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.