Timothy Joseph Montag, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1735 Issued in MN

Practice address

9645 Grove Circle North
Ste 200
Maple Grove, MN 55369-4466

Phone

(763) 201-8191

Fax

(763) 201-8192

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glacial Ridge Hospital Hospital, Glenwood, MN, CCN 241376

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c
• Direct secure messaging: timothy.montag@145284671733764.direct.elationemr.com

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.

• Glacial Ridge Hospital District

  • Family Medicine Physician
  • Brooten, MN
  • NPI 1255348223
  Medicare reassignment Care Compare group
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment
• Glacial Ridge Hospital District

  • Rural Health Clinic/Center
  • Starbuck, MN
  • NPI 1063952026
  NPD
• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  NPD
• Group Health, Inc.

  • Pain Clinic/Center
  • Anoka, MN
  • NPI 1689068462
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Big Lake Spine & Sport, PA

  • Chiropractor
  • Monticello, MN
  • NPI 1295747889
  NPD (past)
• Integrated Care Clinics, PA

  • Physical Therapist
  • Monticello, MN
  • NPI 1396775110
  NPD (past)
• SMS Health Services, PA

  • Chiropractor
  • Sartell, MN
  • NPI 1518903533
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  Care Compare affiliation

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1649348426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIRCLE NORTH",
            "address_2": "STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694466",
            "telephone_number": "763-201-8191",
            "fax_number": "763-201-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIRCLE NORTH",
            "address_2": "STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694466",
            "telephone_number": "763-201-8191",
            "fax_number": "763-201-8192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 19th St S",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Sartell",
            "state": "MN",
            "postal_code": "563774654",
            "country_code": "US",
            "telephone_number": "320-230-7788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTAG",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058133000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "045N0MO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry Momanyi
• Michaela Monetti, PH.D., LP
• Ava Monro
• Cameron Richard Monson, MSW, LICSW
• Paula A Monson, MSW
• Jennifer Hassel Montano-Plaza
• Janeen Montgomery-Peterson, PSY. D., LP
• Carolyn A Montgomery, PA-C
• Ryan Dean Montgomery, PHARMD
• Reagan Paige Moody

• Physician Assistant in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.
• 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.