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AUTUMN MONTVILLE MD
NPI 1962999862
Pediatrics in Saint Paul, MN

Active since April 16, 2018PECOS Enrolled
345 SMITH AVE N, SAINT PAUL, MN 55102(612) 813-6000 Get Directions Write a Review

NPPES record last updated: November 10, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 10, 2022, Aug 25, 2020, Jul 31, 2019 and 2 more (5 updates tracked since 2018).

About Autumn Montville Md NPPES

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

AUTUMN MONTVILLE MD (NPI 1962999862) is an individual pediatrics provider in Saint Paul, Minnesota, licensed in Minnesota (66038) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962999862
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameAUTUMN MONTVILLECredential: MD
Location Address345 SMITH AVE NSaint Paul, MN 55102-2346
Mailing Address345 Smith Ave NSaint Paul, MN 55102-2346 · (612) 813-6000
Phone(612) 813-6000
Sole ProprietorNo
Enumeration DateApril 16, 2018
Last NPPES UpdateNovember 10, 20225 updates tracked since enumeration
NPPES CertifiedNovember 10, 2022
✔ NPI 1962999862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in MN · 66038✔ Licensed in MN · 29302
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
345 SMITH AVE N, Saint Paul, MN 55102
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Other Names 1

Former Name (1)Autumn Tani-winegarden

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Autumn Montville Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Autumn Montville reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Childrens Health Care
Same address
Multi-Specialty
345 NORTH SMITH AVENUE, CHILDRENS SPECIALTY CLINICS STPL
St Paul, MN 55102
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: Children's Health Care
  • 551 clinicians in this Medicare group
NPI 1225132566 (651) 220-6000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55102 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
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.

FAN ZHANG PHARMD
Pharmacist
345 SMITH AVE N
SAINT PAUL, MN 55102
Ramsey County (651) 220-6820
MH HEALTH CARE SERVICES, PC
Nurse Practitioner (Primary Care)
345 SMITH AVE N
SAINT PAUL, MN 55102
Ramsey County (866) 434-3255
DINEL POND M.S., C.G.C.
Genetic Counselor, MS
345 SMITH AVE N, MAILSTOP 61-245
SAINT PAUL, MN 55102
Ramsey County (651) 220-6121
MICHAEL FRAFJORD
Social Worker (Clinical)
345 SMITH AVE N
SAINT PAUL, MN 55102
Ramsey County (651) 220-6000
BREANNA JACOBS PEPIN CNP
Nurse Practitioner
345 SMITH AVE N
SAINT PAUL, MN 55102
Ramsey County (651) 220-6210
HEATHER MARIE MAY NP
Nurse Practitioner (Pediatrics)
345 SMITH AVE N
SAINT PAUL, MN 55102
Ramsey County (651) 220-6296
DR. AMY REBECCA BORDEN D.O.
Pediatrics (Pediatric Emergency Medicine)
345 SMITH AVE N
SAINT PAUL, MN 55102
Ramsey County (651) 220-6914
JENNIFER L FIERRO PA-C
Physician Assistant
345 SMITH AVE N
SAINT PAUL, MN 55102
Ramsey County (651) 220-6705

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 Autumn Montville's NPI number?

The NPI number for Autumn Montville is 1962999862. It was assigned to this individual provider in the NPPES registry on April 16, 2018. The provider is also known as Autumn Tani-Winegarden.

Where is Autumn Montville located?

Autumn Montville practices at 345 Smith Ave N, Saint Paul, MN 55102. The listed phone number is (612) 813-6000.

What is Autumn Montville's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Autumn Montville enrolled in Medicare?

Yes. Autumn Montville is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Autumn Montville's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Autumn Montville reassigns Medicare benefits to Childrens Health Care (St Paul, MN). The 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 Autumn Montville's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Autumn Montville was last updated on November 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.