Active NPI
Paul Coogan Montana, MD
- Internal Medicine Physician
- West Grove, PA
National Provider Identifier
1740740398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD494607
- Practice address
- 390 Vineyard Way
West Grove, PA 19390-8835 - Phone
- (302) 623-1929
- Fax
- (302) 366-1075
- NPI assigned
- Mar 20, 2019
- Last updated
- Jul 22, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | C1-0029343 | DE | |
| Cardiovascular Disease Physician | 207RC0000X | MD494607 | PA | |
| Internal Medicine Physician | 207R00000X | C1-0029343 | DE | |
| Cardiovascular Disease Physician | 207RC0000X | D0106641 | MD | |
| Internal Medicine Physician | 207R00000X | D0106641 | MD | |
| Internal Medicine Physician | 207R00000X | MD494607 | PA | Primary |
Addresses
Primary practice location
390 Vineyard Way
West Grove, PA 19390-8835
Mailing address
1215 Lee St Box 800158
Charlottesville, VA 22908-0816
Phone (434) 243-1000
Other practice location 1
1215 Lee St
Charlottesville, VA 22908-1005
Phone (434) 243-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230705003344 | VA | Order and Referring Only - Cardiovascular Disease (Cardiology) | 0143689489 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116037537 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christiana Care Health Services Inc | Past | Accepting new patients |
Interoperability endpoints
- pmontana573979@direct.healthsystem.virginia.edu
Organizations & group practices 1
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.
-
dba CCHS Concord - Neurology
- Neurology Physician
- Chadds Ford, PA
- NPI 1881228484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1740740398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 LEE ST BOX 800158",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229080816",
"telephone_number": "434-243-1000",
"fax_number": "434-244-7551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 VINEYARD WAY",
"city": "WEST GROVE",
"state": "PA",
"postal_code": "193908835",
"telephone_number": "302-623-1929",
"fax_number": "302-366-1075"
}
],
"practiceLocations": [
{
"address_1": "1215 Lee St",
"address_purpose": "LOCATION",
"city": "Charlottesville",
"state": "VA",
"postal_code": "229081005",
"country_code": "US",
"telephone_number": "434-243-1000",
"fax_number": "434-244-7551",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTANA",
"first_name": "PAUL",
"middle_name": "COOGAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-20",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "DE",
"license": "C1-0029343",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "PA",
"license": "MD494607",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DE",
"license": "C1-0029343",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MD",
"license": "D0106641",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0106641",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD494607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Grove, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.