Individual provider Active NPI

Jonathan Grant Mondragon

  • Emergency Medicine Physician
  • Temple, TX
National Provider Identifier
1124523121
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T0574 Issued in TX
Practice address
2401 South 31St Street
Ms-Ag-407Q
Temple, TX 76508-0001
Phone
(254) 724-5815
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X T0574 TX Primary

Addresses

Primary practice location

2401 South 31St Street
Ms-Ag-407Q
Temple, TX 76508-0001

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20210903001615 TX Practitioner - Emergency Medicine 8921355298 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Emergency Medicine CurrentSince Aug 18, 2021 Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Feb 11, 2025 Accepting new patients
Scott & White Clinic Emergency Medicine CurrentSince Aug 18, 2021 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Feb 4, 2025 Accepting new patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Jun 17, 2021 Accepting new patients

Locations (25 of 26)

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

20171 Chasewood Park Dr
Houston, TX 77070
Phone (713) 355-1000

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

4500 E Sam Houston Pkwy S
Ste 235
Pasadena, TX 77505

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

1317 Lake Pointe Pkwy
Sugar Land, TX 77478
Phone (281) 277-1101

2401 S 31st St
#407Q
Temple, TX 76508
Phone (254) 724-2364

2401 S 31st St
#11
Temple, TX 76508
Phone (254) 724-2518

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

17200 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-2008

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1124523121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 SOUTH 31ST STREET",
            "address_2": "MS-AG-407Q",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDRAGON",
        "first_name": "JONATHAN",
        "middle_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T0574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.