Individual provider Active NPI

Johnathan Scott Monteiro, DPT

  • Sports Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1639637614
Registry record updated Oct 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
30117 Issued in AZ
Practice address
926 E Jackson St Ste 600
Phoenix, AZ 85034-2254
Phone
(480) 886-2253
Fax
(480) 790-4350
NPI assigned
Mar 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 30117 AZ
Ergonomics Physical Therapist 2251E1200X 30117 AZ
Neurology Physical Therapist 2251N0400X 30117 AZ
Orthopedic Physical Therapist 2251X0800X 30117 AZ
Sports Physical Therapist 2251S0007X 30117 AZ Primary

Addresses

Primary practice location

926 E Jackson St Ste 600
Phoenix, AZ 85034-2254

Mailing address

926 E Jackson St Ste 600
Phoenix, AZ 85034-2254
Phone (480) 886-2253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250224003487 AZ Practitioner - Physical Therapist in Private Practice 8921528738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

925 E Jackson St
Suite 600
Phoenix, AZ 85034-2254
Phone (480) 886-2253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30117AZMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athelite Performance Therapy LLC CurrentSince Jan 6, 2025 Accepting new patients
Educated Exercise & Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

925 E Jackson St Ste 600
Phoenix, AZ 85034
Phone (480) 886-2253

926 E Jackson St
Ste 600
Phoenix, AZ 85034
Phone (480) 886-2253

925 E Jackson St Ste 600
Phoenix, AZ 85034
Phone (480) 886-2253

Organizations & group practices 2

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": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729900800000",
    "number": "1639637614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 E JACKSON ST STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342254",
            "telephone_number": "480-886-2253",
            "fax_number": "480-790-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 E JACKSON ST STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342254",
            "telephone_number": "480-886-2253",
            "fax_number": "480-790-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEIRO",
        "first_name": "JOHNATHAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-07",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "30117",
            "primary": false
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": "AZ",
            "license": "30117",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "AZ",
            "license": "30117",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "30117",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "AZ",
            "license": "30117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.