Organization Active NPI

Piere Jacob Montrose M D PA

  • Psychiatry Physician
  • West Palm Beach, FL
National Provider Identifier
1992015184
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME69838 Issued in FL
Legal business name
PIERE JACOB MONTROSE M D PA
Practice address
5762 Okeechobee Blvd
Suite 607
West Palm Beach, FL 33417-4343
Phone
(772) 871-7800
Fax
(772) 871-7822
NPI assigned
Oct 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Authorized official

Name
Pierre Jacob Montrose, MDNPI 1144312638
Title
Owner
Phone
(772) 871-7800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X ME69838 FL Primary

Addresses

Primary practice location

5762 Okeechobee Blvd
Suite 607
West Palm Beach, FL 33417-4343

Mailing address

PO Box 12717
Fort Pierce, FL 34979-2717
Phone (772) 871-7800

Other identifiers 1

IdentifierTypeStateIssuer
254720100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110714000839 FL Part B Supplier - Clinic/Group Practice 0547438624 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Pierce, FL

National Provider Directory

National Provider Directory

Locations

1860 N Lawnwood Cir
Fort Pierce, FL 34950
Phone (561) 466-1500

5762 Okeechobee Blvd
West Palm Beach, FL 33417
Phone (772) 871-7800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1992015184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12717",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349792717",
            "telephone_number": "772-871-7800",
            "fax_number": "772-871-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5762 OKEECHOBEE BLVD",
            "address_2": "SUITE 607",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174343",
            "telephone_number": "772-871-7800",
            "fax_number": "772-871-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIERE JACOB MONTROSE M D PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "MONTROSE",
        "authorized_official_first_name": "PIERRE",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-871-7800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME69838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254720100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.