Individual provider Active NPI

Evelyn Montalvo-Stanton, M.D.

  • Pediatric Pulmonology Physician
  • Las Vegas, NV
National Provider Identifier
1609800523
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
14683 Issued in NV
Practice address
1524 Pinto LN FL 3
Las Vegas, NV 89106-4195
Phone
(702) 992-6888
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 25MA04841400 NJ
Pediatric Pulmonology Physician 2080P0214X 14683 NV Primary

Addresses

Primary practice location

1524 Pinto LN FL 3
Las Vegas, NV 89106-4195

Mailing address

1524 Pinto LN FL 3
Las Vegas, NV 89106-4195
Phone (702) 992-6888

Other practice location 1

90 Bergen St
Doc 5100
Newark, NJ 07103-2425
Phone (973) 972-5779

Other identifiers 3

IdentifierTypeStateIssuer
CS529657OtherNVCONTROL SUBSTANCE
14683OtherNVLICENSE
6106501MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emontalvostanton7368@direct.uhnj.org Direct University Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20051222000023 NJ Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 2769404466 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04841400NJMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Apr 3, 2017 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Apr 3, 2017 Accepting new patients
Practice Associates,Inc Past Accepting new patients
Specialty Care of Practice Associates,PA Past Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

201 Lyons Ave
Ste C9
Newark, NJ 07112
Phone (973) 926-7203

375 Mount Pleasant Ave
West Orange, NJ 07052
Phone (973) 322-6900

Interoperability endpoints

  • Direct secure messaging: emontalvostanton99343@direct.umcsn.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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1609800523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 PINTO LN FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064195",
            "telephone_number": "702-992-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 PINTO LN FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064195",
            "telephone_number": "702-992-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Bergen St",
            "address_2": "DOC 5100",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032425",
            "country_code": "US",
            "telephone_number": "973-972-5779",
            "fax_number": "973-972-5895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTALVO-STANTON",
        "first_name": "EVELYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NJ",
            "license": "25MA04841400",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NV",
            "license": "14683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROL SUBSTANCE",
            "identifier": "CS529657",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "14683",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106501",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emontalvostanton7368@direct.uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "EPIC",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.