Individual provider Active NPI

Carolina M Montes, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Alpharetta, GA
National Provider Identifier
1861480980
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
47041 Issued in TN
Practice address
6240 Shiloh Rd
Alpharetta, GA 30005-8347
Phone
(855) 422-5628
Fax
(205) 579-9387
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 47041 TN
Dermatopathology (Pathology) Physician 207ZD0900X 200780 LA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 200780 LA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 47041 TN Primary

Addresses

Primary practice location

6240 Shiloh Rd
Alpharetta, GA 30005-8347

Mailing address

6240 Shiloh Rd
Alpharetta, GA 30005-8347
Phone (855) 422-5628

Other identifiers 1

IdentifierTypeStateIssuer
1582549MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110324000076 TN Practitioner - Pathology 1951380187
I20180711001853 GA Practitioner - Pathology 1951380187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bakotic Pathology Associates, LLCGroup PAC ID 9436218617, 9 clinicians

Practice addresses (Care Compare)

6240 Shiloh Rd
Alpharetta, GA 30005-8347
Phone (855) 245-2256

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47041TNMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bakotic Pathology Associates, LLC Current Accepting new patients

Locations

6240 Shiloh Rd
Alpharetta, GA 30005
Phone (855) 245-2256

Organizations & group practices 2

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1861480980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 SHILOH RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058347",
            "telephone_number": "855-422-5628",
            "fax_number": "205-579-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 SHILOH RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058347",
            "telephone_number": "855-422-5628",
            "fax_number": "205-579-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES",
        "first_name": "CAROLINA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TN",
            "license": "47041",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "LA",
            "license": "200780",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "200780",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "47041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582549",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.