NPIMap

Individual provider Active NPI

Antonio Wesley Montgomery, M.D.

  • Urology Physician
  • Brooklyn, NY
National Provider Identifier
1821115767
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
269169-1 Issued in NY
Practice address
1 Brookdale PLZ Ste 500
Brooklyn, NY 11212-3139
Phone
(718) 240-8672
Fax
(718) 240-5808
NPI assigned
Mar 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 269169-1 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X MD-22166 HI

Addresses

Primary practice location

1 Brookdale PLZ Ste 500
Brooklyn, NY 11212-3139

Mailing address

1 Brookdale Plaza
Physician Enterprise
Brooklyn, NY 11212-3139
Phone (718) 240-7143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221114001782 HI Practitioner - Urology 4587808613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Georgia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hilo Benioff Medical CenterGroup PAC ID 1254422900, 131 clinicians
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone (808) 932-3000

1285 Waianuenue Ave
Hilo, HI 96720-1209
Phone (808) 432-3000

Hospital & facility affiliations

  • Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005
  • Kau Hospital Hospital, Pahala, HI, CCN 121301
  • North Hawaii Community Hospital, Inc Hospital, Kamuela, HI, CCN 120028

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-22166HIMDUrology Physician
269169-1NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kau Hospital CurrentSince Aug 3, 2022 Accepting new patients
Kau Hospital CurrentSince Aug 3, 2022 Accepting new patients
Hilo Benioff Medical Center CurrentSince Aug 3, 2022 Accepting new patients
Hilo Benioff Medical Center CurrentSince Aug 3, 2022 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Hilo Benioff Medical Center Past Accepting new patients
MMC Pediatrics Faculty Practice Past Accepting new patients

Locations

1285 Waianuenue Ave
#2
Hilo, HI 96720

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Interoperability endpoints

  • Direct secure messaging: antoniomontgomery@mai.allscriptsdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1821115767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLAZA",
            "address_2": "PHYSICIAN ENTERPRISE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-7143",
            "fax_number": "718-240-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ STE 500",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-8672",
            "fax_number": "718-240-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ANTONIO",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "269169-1",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "HI",
            "license": "MD-22166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.