Raul Edward Montejo, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME55755 Issued in FL

Practice address

2401 Frist Blvd Ste 2B
Fort Pierce, FL 34950-4800

Phone

(772) 460-7770

Fax

(407) 369-4295

NPI assigned

May 23, 2005

Last updated

Jul 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Treasure Coast Neurology, Inc

  • Neurology Physician
  • Fort Pierce, FL
  • NPI 1760004501
  Authorized official Same address or phone
• R Edward Montejo MD PA

  • Neurology Physician
  • Fort Pierce, FL
  • NPI 1003095274
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1922001072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD STE 2B",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504800",
            "telephone_number": "772-460-7770",
            "fax_number": "407-369-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD STE 2B",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504800",
            "telephone_number": "772-460-7770",
            "fax_number": "407-369-4295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "942 Seaway Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349493123",
            "country_code": "US",
            "telephone_number": "772-467-0348",
            "fax_number": "772-466-8196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTEJO",
        "first_name": "RAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME55755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273461300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372681900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tcneurology@gmail.com",
            "affiliation": "N",
            "endpointDescription": "TCN email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2401 Frist Blvd Ste 2B",
            "city": "Fort Pierce",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349504800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Palmer Monday, NNP
• Amanda Elise Monde
• Doris Monroe
• Genella Montalbano
• Lourdes Montalva
• Roberto Montlouis
• Jean-Mary Monval
• Monwara Hassan MD PA
• Michael H Mooney, RN
• Ashon G Moore Sr., RRT

• Neurology Physician in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.