Emil I Mondoa, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA05423800 Issued in NJ

Practice address

1600 Haddon Ave
Icn
Camden, NJ 08103-3101

Phone

(856) 757-3988

NPI assigned

Jan 9, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Medexpress, Inc - Delaware

  dba MedExpress - Wilmington Concord Pike

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1255692182
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1124006192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-757-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE",
            "address_2": "ICN",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-757-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDOA",
        "first_name": "EMIL",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05423800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8227004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Moltz
• Sarah Shakir Momin, MD, MPH
• Amanda Monaco
• Rosauro Monasterial, CRNA
• Lori Marie Mondeaux, CRNA
• Nkam Mongwa, CRNA
• Frank Junior Monney de Bebohi, MD
• Julie Rose Montalbano, CRNA
• Claudia Anastasia Montesdeoca, WHNP
• Gerard M Monticollo, D.O.

• Pediatrics Physician in Camden, NJ
• Providers in Camden, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.