Individual provider Active NPI

Colin J Montgomery, PA-C

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1659923704
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
023632 Issued in NY
Practice address
2400 S Clinton Ave BLDG G2ND
Rochester, NY 14618-2668
Phone
(585) 341-7685
Fax
(585) 341-4220
NPI assigned
Jul 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 23632 NY
Medical Physician Assistant 363AM0700X 023632 NY Primary

Addresses

Primary practice location

2400 S Clinton Ave BLDG G2ND
Rochester, NY 14618-2668

Mailing address

2400 S Clinton Ave BLDG G2ND
Rochester, NY 14618-2668
Phone (585) 341-7685

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cmontgomery183136@direct.urmc.rochester.edu Direct
Direct Messaging Address cmontgomery183136@direct.urmc.rochester.edu Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190826000788 NY Practitioner - Physician Assistant 8820326150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

2400 Clinton S Ave F
Rochester, NY 14618-2668
Phone (585) 244-7200

2400 Clinton S Ave G
Rochester, NY 14618-2668
Phone (585) 341-7685

2400 Clinton S Ave H
Rochester, NY 14618-2668
Phone (585) 341-7143

2400 S Clinton Ave
BLDG H
Rochester, NY 14618-2668
Phone (585) 341-7200

Hospital & facility affiliations

  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023632NYMDMedical Physician Assistant
23632NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jun 13, 2019 Accepting new patients
University of Rochester CurrentSince Jun 13, 2019 Accepting new patients
Strong Medical Group Past Accepting new patients

Locations

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

2400 S Clinton Ave
Ste G2
Rochester, NY 14618
Phone (585) 341-7685

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: cmontgomery183136@direct.urmc.rochester.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1659923704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S CLINTON AVE BLDG G2ND",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182668",
            "telephone_number": "585-341-7685",
            "fax_number": "585-341-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S CLINTON AVE BLDG G2ND",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182668",
            "telephone_number": "585-341-7685",
            "fax_number": "585-341-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "COLIN",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-09",
        "last_updated": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "23632",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "023632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmontgomery183136@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmontgomery183136@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.