Individual provider Active NPI

Michael Edward Montejo, M.D.

  • Radiation Oncology Physician
  • Orlando, FL
National Provider Identifier
1659545713
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
ME109892 Issued in FL
Practice address
2501 N Orange Ave
Suite 181
Orlando, FL 32804-4603
Phone
(407) 303-2030
Fax
(407) 303-2040
NPI assigned
Apr 18, 2008
Last updated
Apr 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 6894390-1205 UT
Radiation Oncology Physician 2085R0001X ME109892 FL Primary

Addresses

Primary practice location

2501 N Orange Ave
Suite 181
Orlando, FL 32804-4603

Mailing address

PO Box 1031
Orlando, FL 32802-1031
Phone (407) 872-7786

Other identifiers 2

IdentifierTypeStateIssuer
FE594OtherFLMEDICARE
3667100MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000598 FL Practitioner - Radiation Oncology 2567631252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of South Florida College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

2590 Healing Way
Suite 100
Wesley Chapel, FL 33543-5496
Phone (813) 745-4673

4101 Jim Walter Blvd
Tampa, FL 33607-5775
Phone (888) 860-2778

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6894390-1205UTMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc CurrentSince Jul 1, 2013 Accepting new patients
Heartland Oncology Partners, LLC Radiation Oncology Past Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

Interoperability endpoints

  • Direct secure messaging: michael.montejo@direct.moffitt.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1659545713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1031",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328021031",
            "telephone_number": "407-872-7786",
            "fax_number": "407-872-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 181",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-303-2030",
            "fax_number": "407-303-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEJO",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-18",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "UT",
            "license": "6894390-1205",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME109892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "FE594",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3667100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.