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JAZZMYNE MONTGOMERY MD
NPI 1811516065
Urology in Ann Arbor, MI

Active since April 08, 2020PECOS EnrolledAccepts Medicare Assignment
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109(734) 936-4000 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Jul 8, 2025, Apr 8, 2020 (2 updates tracked since 2020).

About Jazzmyne Montgomery Md NPPES

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

JAZZMYNE MONTGOMERY MD (NPI 1811516065) is an individual urology provider in Ann Arbor, Michigan, licensed in Michigan (4301513820) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Springfield, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2020).

NPPES Registry Identity

NPI1811516065
Entity TypeIndividualFemale
Primary Taxonomy208800000X
Provider Legal NameJAZZMYNE MONTGOMERYCredential: MD
Location Address1500 E MEDICAL CENTER DRAnn Arbor, MI 48109-5000
Mailing Address3621 S State StAnn Arbor, MI 48108-1633 · (734) 647-5299
Phone(734) 936-4000
Sole ProprietorNo
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2020
Enumeration DateApril 8, 2020
Last NPPES UpdateJuly 8, 20252 updates tracked since enumeration
NPPES CertifiedJuly 8, 2025
✔ NPI 1811516065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Licenses✔ Licensed in MI · 4301513820✔ Licensed in IL · 125075468
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
1500 E MEDICAL CENTER DR, Ann Arbor, MI 48109
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Secondary Practice Location 1

Location 1747 N Rutledge StSpringfield, IL 62702-6700 · Phone (217) 545-3262 · Fax (217) 545-7305

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jazzmyne Montgomery Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810311313
PECOS Enrollment IDI20250822002889
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOKMAN SUNG MD
Pathology (Forensic Pathology)
1500 E MEDICAL CENTER DR, 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
ANN ARBOR, MI 48109
Washtenaw County (800) 862-7284
SAMEER DEV SAINI M.D.
Internal Medicine (Gastroenterology)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
KYLE DAVID PERRY MD
Pathology (Cytopathology)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
DR. DAVID ALEXANDER STEWART M.D.
Pediatrics
1500 E MEDICAL CENTER DR, 12TH FLOOR C.S. MOTT CHILDREN'S HOSPITAL ROOM 525
ANN ARBOR, MI 48109
Washtenaw County (734) 763-5302
DR. MICHAEL EDMUND WATSON MD
Pediatrics (Pediatric Infectious Diseases)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
CARRIE KRAEGER PORTER PA-C
Physician Assistant
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-6666
DENISE LYNN BERRY CRNA
Nurse Anesthetist, Certified Registered
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
KETTI SOPHIA PETERSEN MD
Family Medicine (Hospice and Palliative Medicine)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000

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 Jazzmyne Montgomery's NPI number?

The NPI number for Jazzmyne Montgomery is 1811516065. It was assigned to this individual provider in the NPPES registry on April 8, 2020.

Where is Jazzmyne Montgomery located?

Jazzmyne Montgomery practices at 1500 E Medical Center Dr, Ann Arbor, MI 48109. The listed phone number is (734) 936-4000.

What is Jazzmyne Montgomery's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Jazzmyne Montgomery enrolled in Medicare?

Yes. Jazzmyne Montgomery is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jazzmyne Montgomery accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Jazzmyne Montgomery as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jazzmyne Montgomery was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.