Individual provider Active NPI

Roger Montenegro, MD

  • Gastroenterology Physician
  • Lakeland, FL
National Provider Identifier
1790929776
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME102410 Issued in FL
Practice address
130 Pablo St
Lakeland, FL 33803-3818
Phone
(863) 284-5941
Fax
(863) 284-5199
NPI assigned
Apr 22, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME102410 FL Primary

Addresses

Primary practice location

130 Pablo St
Lakeland, FL 33803-3818

Mailing address

1324 Lakeland Hills Blvd
Attn: Medical Staff Office
Lakeland, FL 33805-4543

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmontenegro18021@LRHS.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090801000019 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 9133272586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

3525 Lakeland Hills Blvd
Lakeland, FL 33805-1965
Phone (863) 603-6565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy130
Upper gastrointestinal (GI) endoscopy for acid reflux162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME102410FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Lakeland FL Endoscopy ASC LLC CurrentSince Aug 27, 2024 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients

Locations

130 Pablo St
Lakeland, FL 33803
Phone (863) 284-5064

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

1324 Lakeland Hills Blvd
Ofc
Lakeland, FL 33805
Phone (863) 687-1177

3340 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (407) 451-5099

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

5135 US Highway 98 N
Lakeland, FL 33809
Phone (941) 284-5998

3650 Emergency Ln
Sebring, FL 33870
Phone (800) 382-8345

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rmontenegro18021@lrhs.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790929776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "ATTN: MEDICAL STAFF OFFICE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PABLO ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033818",
            "telephone_number": "863-284-5941",
            "fax_number": "863-284-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENEGRO",
        "first_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-22",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME102410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmontenegro18021@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "130 Pablo St",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338033818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.