NPIMap

Organization Active NPI

Treasure Coast Neurology, Inc

  • Neurology Physician
  • Fort Pierce, FL
National Provider Identifier
1760004501
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
TREASURE COAST NEUROLOGY, INC
Practice address
2401 Frist Blvd Ste 2B
Fort Pierce, FL 34950-4800
Phone
(772) 528-1310
NPI assigned
May 14, 2020
Last updated
May 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Authorized official

Name
Raul Eduardo Montejo, M.D.NPI 1922001072
Title
Owner/Neurologist
Phone
(772) 528-1310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

2401 Frist Blvd Ste 2B
Fort Pierce, FL 34950-4800

Mailing address

2401 Frist Blvd Ste 2B
Fort Pierce, FL 34950-4800
Phone (772) 528-1310

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Tcneurology@gmail.com Health Information Exchange (HIE)
Other URL FortPierce Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

2401 Frist Blvd
Ste 2B
Fort Pierce, FL 34950
Phone (772) 460-7770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1760004501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD STE 2B",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504800",
            "telephone_number": "772-528-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD STE 2B",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504800",
            "telephone_number": "772-528-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST NEUROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "MONTEJO",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "EDUARDO",
        "authorized_official_title_or_position": "OWNER/NEUROLOGIST",
        "authorized_official_telephone_number": "772-528-1310",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Tcneurology@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Medical Practice",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fort Pierce",
            "address_1": "2401 Frist Blvd Ste 2B",
            "city": "Fort Pierce",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349504800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "FortPierce",
            "affiliation": "N",
            "endpointDescription": "tcneurology@gmail.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "FortPierce",
            "address_1": "2401 Frist Blvd Ste 2B",
            "city": "Fort Pierce",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349504800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.