MEDICARE: MONTEROSA CHRONIC CARE MANAGEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1053261107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTEROSA CHRONIC CARE MANAGEMENT

Provider Business Mailing Address
First Line	:	6545 MARKET AVE N STE 100
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:	614-414-2154
Fax Number	:

Provider Business Practice Location Address
First Line	:	139 SOUTHWIND CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-3127
Country	:	US
Telephone Number	:	614-414-2154
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YAZMEEN JOHNSON
Credential	:	LPN
Telephone Number	:	614-414-2154

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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