| Carolyn A Montgomery, PA-C | |
|
9555 Upland Ln N, Maple Grove, MN 55369-4485 | |
| (952) 993-1440 | |
| Not Available |
| Full Name | Carolyn A Montgomery |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 22 Years |
| Location | 9555 Upland Ln N, Maple Grove, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588769913 | NPI | - | NPPES |
| 000000367990 | Other | IN | BCBS - MARY STREET |
| 000000381096 | Other | IN | BCBS - GATEWAY |
| 95005716 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 10000785A (Indiana) | Secondary |
| 363A00000X | Physician Assistant | 13212 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Park Nicollet Clinic | 7911819438 | 1778 |
| Group Health Inc | 1759293954 | 1627 |
| Entity Name | Park Nicollet Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Entity Name | Group Health Plan Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417 |
| Mailing Address | Practice Location Address |
|---|---|
| Carolyn A Montgomery, PA-C 9555 Upland Ln N, Maple Grove, MN 55369-4485 Ph: (952) 993-1440 | Carolyn A Montgomery, PA-C 9555 Upland Ln N, Maple Grove, MN 55369-4485 Ph: (952) 993-1440 |
Kelsey Kostreba, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9825 Hospital Dr Ste 105, Maple Grove, MN 55369 Phone: 763-780-6699 Fax: 763-420-0500 |
Jordan Lillian Anderson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10150 Niagara Ln N # 100, Maple Grove, MN 55369 Phone: 224-213-5886 |
George Onyango, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9855 Hospital Dr Ste 102a, Maple Grove, MN 55369 Phone: 763-581-9220 Fax: 763-581-9221 |
Kristen Marie Finnegan, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9855 Hospital Dr # 102a, Maple Grove, MN 55369 Phone: 763-581-9223 |
Tanner Jesus Verduzco, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12000 Elm Creek Blvd N Ste 300, Maple Grove, MN 55369 Phone: 952-841-2345 Fax: 952-841-2346 |
Tara Barrack, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9555 Upland Ln N, Maple Grove, MN 55369 Phone: 952-993-1440 |
Ms. Gay Wynne Lentfer, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12000 Elm Creek Blvd N, Maple Grove, MN 55369 Phone: 763-420-5822 Fax: 763-420-6387 |