Active NPI
Sara Mundo, PA
- Physician Assistant
- Lexington, KY
National Provider Identifier
1194458745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA3310
- Practice address
- 1000 S Limestone
Lexington, KY 40536-5519 - Phone
- (859) 323-5901
- Fax
- (859) 323-3040
- NPI assigned
- Jul 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | TC014 | KY | |
| Medical Physician Assistant | 363AM0700X | PA3310 | KY | |
| Medical Physician Assistant | 363AM0700X | TC014 | KY | |
| Surgical Physician Assistant | 363AS0400X | PA3310 | KY | |
| Surgical Physician Assistant | 363AS0400X | TC014 | KY | |
| Physician Assistant | 363A00000X | PA3310 | KY | Primary |
Addresses
Primary practice location
1000 S Limestone
Lexington, KY 40536-5519
Mailing address
1000 S Limestone
Lexington, KY 40536-0001
Phone (859) 323-5901
Other practice location 1
650 E Parkway S
Memphis, TN 38104-5519
Phone (970) 219-4266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.76 of 100
- Quality
- 78.19
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.17
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA3310 | KY | MD | Surgical Physician Assistant |
| TC014 | KY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Kentucky | Current | Accepting new patients |
Locations
800 Rose St
Lexington, KY 40536
Phone (859) 257-8562
1000 S Limestone
Lexington, KY 40506
Phone (859) 323-5901
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Lexington, KY
- NPI 1770771974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1194458745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 S LIMESTONE",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405360001",
"telephone_number": "859-323-5901",
"fax_number": "859-323-3040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S LIMESTONE",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405365519",
"telephone_number": "859-323-5901",
"fax_number": "859-323-3040"
}
],
"practiceLocations": [
{
"address_1": "650 E Parkway S",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381045519",
"country_code": "US",
"telephone_number": "970-219-4266",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MUNDO",
"first_name": "SARA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-01",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "TC014",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "KY",
"license": "PA3310",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "KY",
"license": "TC014",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "KY",
"license": "PA3310",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "KY",
"license": "TC014",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA3310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.