Individual provider Active NPI

Gregory A Montes, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1780734442
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011100 Issued in NY
Practice address
330 East 17TH St
New York, NY 10003
Phone
(212) 420-2000
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011100 NY Primary

Addresses

Primary practice location

330 East 17TH St
New York, NY 10003

Mailing address

910 Park Ave
New York, NY 10075-0277
Phone (718) 926-5854

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060330000698 NY Practitioner - Physician Assistant 4486662558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-6500

17 E 102ND St
New York, NY 10029-5204
Phone (212) 659-8551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011100NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 16, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 16, 2019 Accepting new patients
Beth Israel Medical Center Physician Assistant Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Bimc Faculty Practice Physician Assistant Past Accepting new patients

Locations

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1780734442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750277",
            "telephone_number": "718-926-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 EAST 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-420-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.