Waltra Montgomery

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

097294 Issued in NY

Practice address

329 E 149TH St
Bronx, NY 10451-5601

Phone

(718) 769-2698

NPI assigned

Sep 7, 2016

Last updated

Sep 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Interborough Developmental and Consultation Center, Inc.

  dba LSA Recovery

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment NPD
• Interborough Developmental and Consultation Center, Inc.

  dba IDCC Health Services

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1912867433
  NPD

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1811444987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11479 225TH ST",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111227",
            "telephone_number": "516-244-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515601",
            "telephone_number": "718-769-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "WALTRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darnae Montgomery, MSW
• Leslie Montgomery
• Roselyn J Montgomery, REGISTERED NURSE
• Sarah Montgomery, MS, CCC-SLP
• Tevon Montgomery
• Dallin Cole Montierth, DDS
• Elilary Montilla Medrano, MD
• Montofiore Medical Center
• Lucely Montolio
• Diana Vanessa Montoya, FNP

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.