Provider Demographics
NPI:1154333771
Name:MONTOYA, ALBERTO E (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:E
Last Name:MONTOYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16164 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66085-9399
Mailing Address - Country:US
Mailing Address - Phone:901-827-9175
Mailing Address - Fax:
Practice Address - Street 1:16164 LINDEN ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66085-9399
Practice Address - Country:US
Practice Address - Phone:901-827-9175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237834207Q00000X
NY2378341207P00000X
KS0427471207Q00000X
KS04-27471207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7847444OtherAETNA
NYP020237834OtherBLUE SHIELD
KS100315490PMedicaid
NY02747473Medicaid
KS1154333771OtherBCBS
KS100315490JMedicaid
KSKA1209011Medicare PIN
KS1154333771OtherBCBS
NY7847444OtherAETNA
KSKA1398001Medicare PIN
NYP020237834OtherBLUE SHIELD
KS100315490PMedicaid