Andre H. Montazem, M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

208721 Issued in NY

Practice address

1 Gustave L Levy PL
Box 1187
New York, NY 10029-6500

Phone

(212) 241-0316

NPI assigned

Apr 6, 2006

Last updated

Jul 13, 2026By the provider in NPPES

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 1

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

• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty practice Group

  • Orthopaedic Surgery Physician
  • Elmhurst, NY
  • NPI 1609120674
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Elmhurst, NY
  • NPI 1437403409
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1619221686
  NPD
• Mount Sinai Diagnostic and Treatment Center

  • Clinic/Center
  • New York, NY
  • NPI 1669476156
  NPD (past)
• Mount Sinai School of Medicine

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Internal Medicine Physician
  • Elmhurst, NY
  • NPI 1013147313
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1740242437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 ROOSEVELT AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075061539",
            "telephone_number": "862-684-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "BOX 1187",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAZEM",
        "first_name": "ANDRE",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "208721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01795293",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Agustina Montano, LMSW
• Dechantal C Montano, OTR/L
• Jeffrey Montano, BCBA, LBA
• Joseph J. Montano, ED.D.
• Amberlee Montarella, NURSE PRACTITIONER F
• Lona Monte, MSW
• Ana Monteagudo, M.D.
• Maria G. Montealegre, ACNP
• Minnette Montecillo
• Montefiore Medical Center

• Oral & Maxillofacial Surgery (D.M.D.) in New York, NY
• Providers in New York, NY by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New York

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

Verify at the official NPI Registry.