MRS. CRYSTAL A MONTGOMERY (F.N.P.) – Family Nurse Practitioner, NPI 1578898391
Family Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for MRS. CRYSTAL A MONTGOMERY (F.N.P.)
1600 SAINT JOHNS BLVD STE 101
MAPLEWOOD, MN 551091190
Phone: (651) 232-5354
Type: Location
11269 Jefferson Hwy N
Champlin, MN 553163123
Phone: (763) 236-0600
Type: Location
Park Av, 701, Park Avenue South, Minneapolis, Hennepin County, Minnesota, 55415, United States
MINNEAPOLIS, MN 554151623
Phone: (574) 298-7797
Type: Location
15820, Dakota Street Northwest, Andover, Anoka County, Minnesota, 55304, United States
ANDOVER, MN 553042329
Phone: (574) 298-7797
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2011-04-13
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 |
|---|---|---|---|---|
| I20110413000554 | I | Nurse Practitioner | MN | 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 |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 43 | 23 | $0 |
Insurance plans in this area (ZIP 55109)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| Qualified Audiologist | MN | |
| Family Practice | MN | |
| - | MN | |
| Family Practice | MN | |
| Nurse Practitioner | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
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