Individual provider Active NPI

Mercedes Noelle Montalvo, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1871836320
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A133176 Issued in CA
Practice address
701 W Cesar Estrada Chavez Ave
#201
Los Angeles, CA 90012
Phone
(213) 217-5300
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Internal Medicine Physician 207R00000X A133176 CA Primary

Addresses

Primary practice location

701 W Cesar Estrada Chavez Ave
#201
Los Angeles, CA 90012

Mailing address

701 W Cesar Estrada Chavez Ave
#201
Los Angeles, CA 90012
Phone (213) 217-5300

Other identifiers 1

IdentifierTypeStateIssuer
MM3232267556OtherCALAC-USC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160713001600 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2860784725

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133176CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1871836320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W CESAR ESTRADA CHAVEZ AVE",
            "address_2": "#201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90012",
            "telephone_number": "213-217-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W CESAR ESTRADA CHAVEZ AVE",
            "address_2": "#201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90012",
            "telephone_number": "213-217-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALVO",
        "first_name": "MERCEDES",
        "middle_name": "NOELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A133176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAC-USC",
            "identifier": "MM3232267556",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.