Mickey Mondragon, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC2250 Issued in NM

Practice address

2441 San Pedro Dr NE
Albuquerque, NM 87110-4101

Phone

(505) 403-6512

NPI assigned

Jul 27, 2021

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• CO HMO
• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
• CO HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Root and Stem Chiropractic LLC

  • Chiropractor
  • Albuquerque, NM
  • NPI 1811858962
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1023781812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 SAN PEDRO DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104101",
            "telephone_number": "505-403-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 SAN PEDRO DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104101",
            "telephone_number": "505-403-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDRAGON",
        "first_name": "MICKEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-27",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "DC2250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Mondragon
• Andrea Mondragon
• Benicio Andres Mondragon
• Carmela C Mondragon, CNP
• Jannette Alicia Mondragon
• Rachel Mondragon
• Teresa Louise Mondragon, D.D.S.
• Moheb Moneim, MD
• Lewis Monette, SW
• Nicole Monette, LCSW

• Chiropractor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.