NPIMap

Individual provider Active NPI

Daniel Lee Montgomery, MD

  • Emergency Medicine Physician
  • Rapid City, SD
National Provider Identifier
1922395656
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
50465 Issued in AZ
Practice address
502 E Monroe St
Rapid City, SD 57701-1400
Phone
(605) 719-4060
Fax
(605) 719-4012
NPI assigned
Jul 1, 2011
Last updated
Oct 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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 NU
Emergency Medicine Physician 207P00000X 50465 AZ Primary

Addresses

Primary practice location

502 E Monroe St
Rapid City, SD 57701-1400

Mailing address

502 E Monroe St
Rapid City, SD 57701-1400
Phone (602) 501-0187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150819008773 AZ Practitioner - Emergency Medicine 1254658693 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Sanford School of Medicine of University of South Dakota, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America- Arizona, PCGroup PAC ID 1850541970, 89 clinicians

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

14502 W Meeker Blvd
Sun City, AZ 85375-5282
Phone (623) 214-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
81.6
Improvement activities
40
Cost
77.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50465AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Dec 1, 2020 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Cep America-Arizona, PC Emergency Medicine CurrentSince Jan 4, 2016 Accepting new patients
Cep America - Arizona PC Emergency Medicine CurrentSince Jan 4, 2016 Accepting new patients
Progressive Medical Associates PLLC Emergency Medicine CurrentSince Oct 17, 2022 Accepting new patients
Cep America- Arizona, PC Emergency Medicine Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1922395656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 E MONROE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011400",
            "telephone_number": "602-501-0187",
            "fax_number": "605-719-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E MONROE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011400",
            "telephone_number": "605-719-4060",
            "fax_number": "605-719-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "DANIEL",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "50465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.