Individual provider Active NPI

Chantelle L Mundy, O.D.

  • Optometrist
  • Columbus, OH
National Provider Identifier
1235378415
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5809 Issued in OH
Practice address
915 Olentangy River Rd
Columbus, OH 43212-3153
Phone
(614) 293-8116
Fax
(614) 293-3555
NPI assigned
Feb 12, 2009
Last updated
Apr 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5809 OH Primary

Addresses

Primary practice location

915 Olentangy River Rd
Columbus, OH 43212-3153

Mailing address

915 Olentangy River Rd
Columbus, OH 43212-3153
Phone (614) 293-8116

Other identifiers 1

IdentifierTypeStateIssuer
3001049MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090601000585 OH Practitioner - Optometry 8426107095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Eye Physicians and Surgeons, LLCGroup PAC ID 5698671881, 45 clinicians

Practice addresses (Care Compare)

6100 N Hamilton Rd
Westerville, OH 43081-2062
Phone (614) 293-8116

915 Olentangy River Rd
FL 5
Columbus, OH 43212-3153
Phone (614) 293-8116

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5809OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Eye Physicians and Surgeons LLC CurrentSince Dec 1, 2010 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

915 Olentangy River Rd
Columbus, OH 43212

915 Olentangy River Rd
Fl 5
Columbus, OH 43212

Interoperability endpoints

  • Direct secure messaging: cmundy16222@direct.osumc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1235378415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153",
            "telephone_number": "614-293-8116",
            "fax_number": "614-293-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153",
            "telephone_number": "614-293-8116",
            "fax_number": "614-293-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDY",
        "first_name": "CHANTELLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001049",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.