Individual provider Active NPI

Gregg Joseph Montalto, M.D.

  • Pediatric Adolescent Medicine Physician
  • Chicago, IL
National Provider Identifier
1710073416
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
036.147444 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637
Phone
(773) 702-7506
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 036.147444 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637

Mailing address

8901 Wisconsin Avenue
Attn: Department of Pediatrics
Bethesda, MD 20889
Phone (301) 295-4910

Other practice location 1

8901 Wisconsin Avenue
Attn: Department of Pediatrics
Bethesda, MD 20889
Phone (301) 295-4910

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190219000300 IL Practitioner - Pediatric Medicine 0446598379 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.147444ILMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Friend Family Health Center Inc Current Accepting new patients
Friend Family Health Center Inc CurrentSince Mar 23, 2019 Accepting new patients
Friend Family Health Center Inc CurrentSince Mar 23, 2019 Accepting new patients
The University of Chicago Medical Center CurrentSince Jan 1, 2019 Accepting new patients
The University of Chicago Medical Center CurrentSince Jan 1, 2019 Accepting new patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

Interoperability endpoints

  • Direct secure messaging: gmontalto172459@uchospital.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1710073416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVENUE",
            "address_2": "ATTN: DEPARTMENT OF PEDIATRICS",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20889",
            "telephone_number": "301-295-4910",
            "fax_number": "301-295-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-7506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Wisconsin Avenue",
            "address_2": "Attn: Department of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "20889",
            "country_code": "US",
            "telephone_number": "301-295-4910",
            "fax_number": "301-295-6173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTALTO",
        "first_name": "GREGG",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036.147444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.