Individual provider Active NPI

Stephanie Mundo, RN

  • Community Health Registered Nurse
  • New York, NY
National Provider Identifier
1194396168
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
766361 Issued in NY
Practice address
450 W 17TH St Apt 523
New York, NY 10011-5846
Phone
(516) 661-8152
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC1500X 766361 NY Primary

Addresses

Primary practice location

450 W 17TH St Apt 523
New York, NY 10011-5846

Mailing address

450 W 17TH St Apt 523
New York, NY 10011-5846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
766361NYMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1194396168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W 17TH ST APT 523",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W 17TH ST APT 523",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115846",
            "telephone_number": "516-661-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDO",
        "first_name": "STEPHANIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "NY",
            "license": "766361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.