Jon Edwin Mundall, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A96027 Issued in CA

Practice address

475 Bruce St
Suite 700
Yreka, CA 96097-9553

Phone

(530) 842-4445

Fax

(530) 842-9054

NPI assigned

Jul 25, 2006

Last updated

Oct 16, 2008By 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 WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

96.29 of 100Reported as group

Quality

90.36

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services - Washington

  dba Providence Mount Carmel Hospital

  • Critical Access Hospital
  • Colville, WA
  • NPI 1003067679
  Medicare reassignment NPD
• Providence Health & Services - Washington

  dba Providence Mount Carmel Hospital

  • Critical Access Hospital
  • Colville, WA
  • NPI 1841442332
  Medicare reassignment NPD
• Steve Kolpacoff MD

  dba Stephen Kolpacoff MD

  • Internal Medicine Physician
  • Yreka, CA
  • NPI 1518138544
  NPD (past)
• Trinity County

  dba Trinity County Behavioral Health Services

  • Community/Behavioral Health Agency
  • Weaverville, CA
  • NPI 1245432855
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1063435576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1167",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960971167",
            "telephone_number": "530-842-9800",
            "fax_number": "530-842-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "address_2": "SUITE 700",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960979553",
            "telephone_number": "530-842-4445",
            "fax_number": "530-842-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDALL",
        "first_name": "JON",
        "middle_name": "EDWIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A96027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qazi M Mohsin, MD
• Lucas Morris
• Patricia Jeannette Morrison, RN, PHN, NP
• Joseph Mott
• Mount Shasta Physicians Inc
• Katherine D Munoz
• Randy Terry Murieen
• Paul Douglas Nagy
• Steven L Nelson, MD
• Nan Lee Newton, MA

• Family Medicine Physician in Yreka, CA
• Providers in Yreka, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.
• 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.