TARA LYN MONTGOMERY-JOHNSON (PA-C) – Physician Assistant, NPI 1366490005
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TARA LYN MONTGOMERY-JOHNSON (PA-C)
215 E MANSION ST STE 2D
MARSHALL, MI 490681167
Phone: (269) 789-0015
Type: Mailing
41850 W 11 MILE RD STE 202
NOVI, MI 483751857
Phone: (248) 860-4634
Type: Mailing
90 N MICHIGAN AVE
COLDWATER, MI 490361527
Phone: (248) 860-4634
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $51.
Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.
Last reported payment date: 2023-05-03 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($51).
Total Amount
$51
General + Research + Ownership
Payments
1
Total payment records
General Amount
$51
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $51 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-10-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051027000279 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 1,175 | 321 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 623 | 257 | $0 |
| 99497 | Advance care planning, first 30 minutes | 161 | 160 | $0 |
| 99316 | Nursing facility discharge management, more than 30 minutes | 114 | 113 | $0 |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 101 | 24 | $0 |
Insurance plans in this area (ZIP 49068)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Family Practice | MI | |
| G A S T R O E N T E R O L O G Y | MI | |
| - | MI | |
| General Surgery | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI |
Reviews
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