Individual provider Active NPI

Kristofer Montoya, MD

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1679101323
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301513738 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2600
Fax
(313) 876-1305
NPI assigned
Mar 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1018148 MA
Emergency Medicine Physician 207P00000X D97424 MD
Emergency Medicine Physician 207P00000X 4301513738 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

1830 E Monument St Ste 6-100
Baltimore, MD 21287-0020
Phone (410) 955-3380

Other practice location 2

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Other practice location 3

55 Fruit St
Boston, MA 02114-2621
Phone (617) 724-4133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, MA, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230921001657 MD Practitioner - Emergency Medicine 0648691824 Reassigns benefits to 1 organization
I20240701000221 MA Practitioner - Emergency Medicine 0648691824 Reassigns benefits to 3 organizations
I20250513002044 MI Practitioner - Emergency Medicine 0648691824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Emergency Medicine CurrentSince Apr 22, 2024 Accepting new patients
Henry Ford Health System CurrentSince Apr 15, 2025 Accepting new patients
Henry Ford Health System Current Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2024 Accepting new patients
Johns Hopkins University CurrentSince Jun 20, 2023 Accepting new patients
Johns Hopkins University Emergency Medicine CurrentSince Jun 20, 2023 Accepting new patients
Henry Ford Health System Emergency Medicine CurrentSince Apr 15, 2025 Accepting new patients
Johns Hopkins University Current Accepting new patients
Massachusetts General Physicians Organization Inc Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

75 Francis St
Boston, MA 02115

4940 Eastern Ave
Baltimore, MD 21224

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Organizations & group practices 9

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 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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1679101323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 E Monument St Ste 6-100",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870020",
            "country_code": "US",
            "telephone_number": "410-955-3380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-724-4133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "KRISTOFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "1018148",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D97424",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301513738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.