Nicole Marie Mondoux, OP

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT12619 Issued in CA

Practice address

3060 E 9TH St Ste B
Oakland, CA 94601-2925

Phone

(510) 535-5500

Fax

(510) 535-4225

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1053487033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 E 9TH ST STE B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012925",
            "telephone_number": "510-535-5500",
            "fax_number": "510-535-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDOUX",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "OP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE NPI",
            "identifier": "1124035159",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3555 Whipple Rd",
            "city": "Union City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945871507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Ann Monahan, N.P.
• Paul M Monasevitch
• Jenae Monasterial
• Michele Moncrief
• Sampa Mondal, PHARM.D.
• Katia Liliana Mondragon Rodriguez
• Valerie Mondragon
• Raquel Veronica Monge, LCSW
• Juliette Clara Monheit, RN, CNS, P/MH NURSE
• Daniel Lawrence Monin, MD

• Optometrist in Oakland, CA
• Providers in Oakland, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.