Simone Nicole Boeckmann Montgomery, MD, MPH

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A180644 Issued in CA

Practice address

1240 S Westlake Blvd Ste 205
Westlake Village, CA 91361-1992

Phone

(805) 495-0551

Fax

(805) 494-1154

NPI assigned

Mar 9, 2020

Last updated

Aug 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Dermatology

Education

University of Southern California Keck School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of Westlake Village PCGroup PAC ID 7416352539, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Integrated Dermatology of Westlake Village, PC

  • Dermatology Physician
  • Westlake Village, CA
  • NPI 1295302917
  Medicare reassignment Care Compare group NPD
• James Y. Wang, MD, Inc.

  dba Metropolis Dermatology

  • Dermatology Physician
  • Los Angeles, CA
  • NPI 1538640669
  Medicare reassignment NPD
• Dermatology Associates of Westlake

  • Specialist
  • Westlake Village, CA
  • NPI 1265401251
  NPD

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1699300731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S WESTLAKE BLVD STE 205",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611992",
            "telephone_number": "805-495-0551",
            "fax_number": "805-494-1154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State Street",
            "address_2": "General Hospital, Dermatology - Rm 3250",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-409-3360",
            "fax_number": "323-226-2654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "SIMONE",
        "middle_name": "NICOLE BOECKMANN",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A180644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monroe Operations, LLC (Newport Academy-Westlake Village)
• Anthony Joseph Montella, D.D.S.
• Monteverdi Individual, Family, and Couple (Monteverdi Psychotherapy Services)
• Eliza Nielsen Monteverdi, MA MFT
• Nicole N Montgomery, NURSE PRACTITIONER
• Toby Ann Montoure
• Roy Randy Moon
• Azia Moore, BA
• Jason William Moore, D.C., H.B.K.
• Lindsay Moore

• Dermatology Physician in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.

Verify at the official NPI Registry.