Active NPI
Michael Edward Montejo, M.D.
- Radiation Oncology Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- ME109892
- 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, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FE594 | Other | FL | MEDICARE |
| 3667100 | Medicaid | FL |
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
Enrollment records 1
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 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 6894390-1205 | UT | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc | Current | 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
- 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.
-
dba Moffitt Medical Group
- Hematology & Oncology Physician
- Tampa, FL
- NPI 1306833595
-
- Radiation Oncology Physician
- Sebring, FL
- NPI 1932158565
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Tampa, FL
- NPI 1780653618
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.