Mandrill Deangelo Montgomery, CRNA in Greenville, SC - Medicare Certified Registered Nurse Anesthetist (crna)

Mandrill Deangelo Montgomery, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Greenville, South Carolina. He graduated from nursing school in 2008 and has 16 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Spartanburg Medical Center and his current practice location is 701 Grove Rd, Greenville, South Carolina. You can reach out to his office (for appointments etc.) via phone at (864) 454-7111.

Mandrill Deangelo Montgomery is licensed to practice in South Carolina (license number 101035) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1255505665.

Contact Information

	Mandrill Deangelo Montgomery, CRNA
	701 Grove Rd, Greenville, SC 29605-5611
	(864) 454-7111
	(864) 455-6441

Map and Direction

Provider's Profile

Full Name	Mandrill Deangelo Montgomery
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	16 Years
Location	701 Grove Rd, Greenville, South Carolina
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mandrill Deangelo Montgomery graduated from nursing school in 2008

NPI Data:

NPI Number: 1255505665
Provider Enumeration Date: 04/16/2008
Last Update Date: 03/19/2014

Medicare PECOS Information:

PECOS PAC ID: 5991878423
Enrollment ID: I20080717000004

Medical Identifiers

Medical identifiers for Mandrill Deangelo Montgomery such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255505665	NPI	-	NPPES
57-6007863	Other	SC	TAX ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	101035 (South Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Spartanburg Medical Center	Spartanburg, SC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Spartanburg Medical Center	3072425297	843

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mandrill Deangelo Montgomery allows following entities to bill medicare on his behalf.

Entity Name	Spartanburg Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043309917 PECOS PAC ID: 3072425297 Enrollment ID: O20031105000129

Entity Name	Pelham Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962644773 PECOS PAC ID: 2365519097 Enrollment ID: O20090602000210

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mandrill Deangelo Montgomery is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mandrill Deangelo Montgomery, CRNA 1 Independence Pt, Suite 212, Greenville, SC 29615-4545 Ph: (864) 797-6307	Mandrill Deangelo Montgomery, CRNA 701 Grove Rd, Greenville, SC 29605-5611 Ph: (864) 454-7111

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Greenville, SC

Paul Derek Street, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7 Independence Pt Ste 300, Greenville, SC 29615 Phone: 864-522-3700 Fax: 864-522-3705
Ashley Ann Alguire, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7 Independence Pt Ste 300, Greenville, SC 29615 Phone: 864-522-3700 Fax: 864-522-3705
Mr. J Ross Thomas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7 Independence Pt Ste 300, Greenville, SC 29615 Phone: 864-522-3700 Fax: 864-522-3705
George R Sweet, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 701 Grove Rd, Anesthesia Dept, Greenville, SC 29605 Phone: 864-455-7111
Jennifer Webb George, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 Grove Rd, Greenville, SC 29605 Phone: 864-455-7111 Fax: 864-455-6441
Amanda Tipton Larson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 Grove Rd, Greenville, SC 29605 Phone: 864-522-2286
Tyler Withrow, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 Grove Rd, Greenville, SC 29605 Phone: 864-455-7000

Mandrill Deangelo Montgomery, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Greenville, SC