Gavriella Grace Montoya Y Tierney, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSA0220211 Issued in NM

Practice address

630 Haines Ave NW
Albuquerque, NM 87102-1226

Phone

(505) 268-5611

Fax

(505) 268-5736

NPI assigned

Sep 24, 2021

Sex

Female

Sole proprietor

No

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 MT

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

Undefined Non-Physician Type (Specify)

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/b2651172-99ed-43dd-9814-59d9dbd8df43/

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.

• Sapphire Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Hamilton, MT
  • NPI 1003146812
  Medicare reassignment NPD
• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1144437294
  NPD (past)
• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1710512199
  NPD (past)

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1871264267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 5TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871073509",
            "telephone_number": "505-485-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 HAINES AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021226",
            "telephone_number": "505-268-5611",
            "fax_number": "505-268-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOYA Y TIERNEY",
        "first_name": "GAVRIELLA",
        "middle_name": "GRACE",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0220211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Ines Montgomery, M.S., CCC-SLP
• Jessica M. Monthan, M.D.
• Maria Andrea Montiel, CNM
• Miguel A Montiel, SLP
• Rachel Marie Montiel, LMHC
• Daniela Romero Montoya-Barthelemy, MPH, SEP, LMSW
• Joshua Montoya-Gandertt
• Savanna Montoya-Villagran
• Abrian Montoya, CPT,CES,FNS
• Aimee Montoya

• Addiction (Substance Use Disorder) Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.