Elaine Alexis Montouris, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD052220L Issued in PA

Practice address

136 Smoke Rise Dr
Warren, NJ 07059-6821

Phone

(908) 581-5668

Fax

(732) 271-5853

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1992878334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SMOKE RISE DR",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070596821",
            "telephone_number": "908-581-5668",
            "fax_number": "732-271-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SMOKE RISE DR",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070596821",
            "telephone_number": "908-581-5668",
            "fax_number": "732-271-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOURIS",
        "first_name": "ELAINE",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA00071469",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD052220L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mira Vie at Warren Opco LLC
• MJ Care Services LLC
• MMM Health Services, Inc.
• Jessica M Mobus
• Madhu Mohan, D.M.D.
• Diana Montoya
• Nancy H Montville, PNP
• Melissa Marie Morano, MS, OTR, CEIM
• Demi Moreland
• Dina Morley, LCSW

• Internal Medicine Physician in Warren, NJ
• Providers in Warren, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.