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JESUS MONTESANO MD MEDICAL CENTER
NPI 1104636208
Clinic/Center - Primary Care in Hialeah, FL

Active since January 10, 2025CLIA 10D2319651 · Waiver
664 E 25TH ST STE 101, HIALEAH, FL 33013(645) 229-1317 Get Directions Write a Review

NPPES record last updated: February 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 19, 2025, Jan 10, 2025 (2 updates tracked since 2025).

About Jesus Montesano Md Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESUS MONTESANO MD MEDICAL CENTER (NPI 1104636208) is a healthcare organization registered as a primary care in Hialeah, Florida and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through March 4, 2027 and lists Jesus Montesano, Owner, as its authorized official.

NPPES Registry Identity

NPI1104636208
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameJESUS MONTESANO MD MEDICAL CENTER
Location Address664 E 25TH ST STE 101Hialeah, FL 33013-3806
Mailing Address664 E 25th St Ste 101Hialeah, FL 33013-3806 · (645) 229-1317
Phone(645) 229-1317
Organization SubpartNo
Authorized OfficialJesus MontesanoOwner · (645) 229-1317
Enumeration DateJanuary 10, 2025
Last NPPES UpdateFebruary 19, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2025
✔ NPI 1104636208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedFamily MedicineTaxonomy 207Q00000X
664 E 25TH ST STE 101, Hialeah, FL 33013
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jesus Montesano Md Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jesus Montesano MD Medical Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jesus Montesano, MD
Internal Medicine
NPI 1295836005
664 EAST 25TH STREET SUITE # 101
Hialeah, FL 33013
(305) 835-7625
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2319651

Jesus Montesano MD Medical Center LLC · Hialeah, FL
Active · expires Mar 4, 2027
CLIA Number10D2319651
Laboratory TypePhysician Office
Certificate Effective DateMarch 5, 2025
Certificate Expiration DateMarch 4, 2027
Laboratory DirectorJesus Montesano
Laboratory Phone(645) 229-1317
Laboratory LocationJesus Montesano MD Medical Center LLC664 East 25 Street Suite 101, Hialeah, FL 33013
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesus Montesano MD Medical Center's NPI number?

The NPI number for Jesus Montesano MD Medical Center is 1104636208. It was assigned to this organization in the NPPES registry on January 10, 2025.

Where is Jesus Montesano MD Medical Center located?

Jesus Montesano MD Medical Center is located at 664 E 25th St Ste 101, Hialeah, FL 33013. The listed phone number is (645) 229-1317.

What is Jesus Montesano MD Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Jesus Montesano MD Medical Center enrolled in Medicare?

Yes. Jesus Montesano MD Medical Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jesus Montesano MD Medical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Jesus Montesano MD Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Jesus Montesano MD Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2319651) is associated with this NPI, valid through March 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jesus Montesano MD Medical Center was last updated on February 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.