Kyle David Montgomery, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD064400L Issued in PA

Practice address

2317 E Westmoreland St
Phila, PA 19134-4529

Phone

(215) 926-3115

Fax

(215) 926-3100

NPI assigned

Dec 15, 2005

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 11

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Temple Physicians Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1942444088
  Medicare reassignment NPD
• Temple Physician Inc.

  • Internal Medicine Physician
  • Feasterville Trevose, PA
  • NPI 1174497366
  NPD
• Temple Physicians Inc

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1679978092

  Family Medicine

  NPD
• Temple Physicians Inc

  • Family Medicine Physician
  • Flourtown, PA
  • NPI 1952642936
  NPD (past)

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1679559223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-926-3115",
            "fax_number": "215-926-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 E WESTMORELAND ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191344529",
            "telephone_number": "215-926-3115",
            "fax_number": "215-926-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KYLE",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD064400L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080164274",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLA",
            "identifier": "30036753",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2319021",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO HEALTH",
            "identifier": "6052",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2Y7472",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "028886",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH AMERICA",
            "identifier": "497977",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLA",
            "identifier": "30036754",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5466743",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001822599",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1458249",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell a Anolik MD PC
• Mitchell Martin Healthcare
• MK Reliable Transportation LLC
• Modern Limb and Brace Co
• Sky Monarch, DC
• Latoya Montgomery
• Daniel Alexander Monti, MD
• Terry Ilene Moore-Brown, MA
• Elizabeth Ann Moore, B.A.
• Natalie Morales

• Family Medicine Physician in Phila, PA
• Providers in Phila, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.