Ensign Montgomery LLC
NPI 1104825520ActiveOrganization· Skilled Nursing Facility· Santa Rosa, CA
Skilled Nursing Facility in Santa Rosa, California, registered in NPPES in July 2005. The authorized official on file is Soon Burnam, Treasurer. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1104825520 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 18, 2005 |
| Last updated in NPPES | Feb 17, 2021 |
| Certified by provider | Feb 17, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | 010000062 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (CA) |
|---|
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