Individual provider Active NPI

Jennifer Monti, M.D.

  • Cardiovascular Disease Physician
  • Scarborough, ME
National Provider Identifier
1962729442
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD20969 Issued in ME
Practice address
96 Campus Dr
Suite 1
Scarborough, ME 04074-7163
Phone
(207) 885-9905
Fax
(207) 396-5600
NPI assigned
Apr 23, 2010
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X MD20969 ME
Cardiovascular Disease Physician 207RC0000X 82780 WI
Cardiovascular Disease Physician 207RC0000X MD20969 ME Primary

Addresses

Primary practice location

96 Campus Dr
Suite 1
Scarborough, ME 04074-7163

Mailing address

300 Southborough Dr
Suite 201
South Portland, ME 04106-6914
Phone (207) 661-2000

Other practice location 1

700 S Park St Ste A
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 2

IdentifierTypeStateIssuer
1962729442MedicaidME
1962729442MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jmonti481099@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160919002827 ME Practitioner - Cardiovascular Disease (Cardiology) 2062662745 Reassigns benefits to 2 organizations
I20181205000843 NH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2062662745 Reassigns benefits to 1 organization
I20230727000441 WI Practitioner - Cardiovascular Disease (Cardiology) 2062662745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

360 Broadway
Bangor, ME 04401-3979

700 S Park St
Suite a
Madison, WI 53715-1830
Phone (608) 260-2900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20969MEMDCardiovascular Disease Physician
82780WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Internal Medicine CurrentSince Jul 17, 2023 Accepting new patients
Maine Medical Partners Current Accepting new patients
St. Joseph Hospital CurrentSince May 21, 2024 Accepting new patients
Maine Medical Partners CurrentSince Jun 27, 2016 Accepting new patients
Maine Medical Partners Cardiovascular Disease CurrentSince Jun 27, 2016 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 17, 2023 Accepting new patients

Locations

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

96 Campus Dr
Ste 1
Scarborough, ME 04074
Phone (207) 396-5611

300 Southborough Dr
Ste 201
South Portland, ME 04106
Phone (207) 661-2000

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

700 S Park St
Ste A
Madison, WI 53715
Phone (608) 260-2900

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: jmonti2762279@direct.bsmhealth.org
  • Direct secure messaging: jmonti481099@direct-ehr-ssmhc.com

Organizations & group practices 6

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 7

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1962729442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SOUTHBOROUGH DR",
            "address_2": "SUITE 201",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066914",
            "telephone_number": "207-661-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "address_2": "SUITE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163",
            "telephone_number": "207-885-9905",
            "fax_number": "207-396-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Park St Ste A",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTI",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD20969",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "82780",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "MD20969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962729442",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962729442",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmonti481099@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jmonti481099@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.