Kevin Farrell Montgomery, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

26324 Issued in WA

Practice address

125 130TH St SE
Everett, WA 98208-6400

Phone

(425) 385-2263

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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.

• Northwest Weight Loss Surgery, PLLC

  • Ambulatory Surgical Clinic/Center
  • Everett, WA
  • NPI 1487693800
  NPD (past)
• Sound Surgeons PLLC

  • Ambulatory Surgical Clinic/Center
  • Everett, WA
  • NPI 1396123865
  NPD (past)
• Sound Weight and Wellness PLLC

  • Obesity Medicine (Internal Medicine) Physician
  • Everett, WA
  • NPI 1275105728
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 9, 2015 through Jun 9, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2016.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1962448639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 130TH ST SE",
            "address_2": "SUITE 100",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-385-2263",
            "fax_number": "425-385-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 130TH ST SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086400",
            "telephone_number": "425-385-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KEVIN",
        "middle_name": "FARRELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "26324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinh Ngoc Monroe
• Chelsea Carty Monsees
• Franco Monteza, MD
• Bonnie Michele Montgomery, M.S.
• Gary Dale Montgomery, PA-C
• Ana Maria Montoya-Alm, PA-C
• Brenda Montoya, R.N
• Valarie Moon
• Bridget Mooney, CCC SLP
• Dawn B Moore, ARNP

• All providers in Everett, WA
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.