Individual provider Active NPI

Sara Mundo, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1194458745
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3310 Issued in KY
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

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830003790 KY Practitioner - Physician Assistant 5092178558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
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

LicenseStateTypeSpecialty
PA3310KYMDSurgical Physician Assistant
TC014KYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Aug 15, 2023 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.

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

Verify at the official NPI Registry.