Individual provider Active NPI

Monda T Waked, DC

  • Chiropractor
  • Mentor, OH
National Provider Identifier
1245375351
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3621 Issued in OH
Practice address
7249 Center St Ste 2
Mentor, OH 44060-4907
Phone
(440) 205-9910
Fax
(440) 974-2400
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3621 OH Primary

Addresses

Primary practice location

7249 Center St Ste 2
Mentor, OH 44060-4907

Mailing address

7257 Center St
Mentor, OH 44060-4907
Phone (440) 205-9910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000564 OH Practitioner - Chiropractic 8123151685 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ac PT Inc CurrentSince Jul 16, 2021 Accepting new patients
Chiro Life LLC Chiropractor CurrentSince Apr 27, 2010 Accepting new patients
Mentor Chiropractic and Rehabilitation Inc Chiropractor Past Accepting new patients

Locations

7257 Center St
Mentor, OH 44060
Phone (440) 205-9910

7211 Center St
Mentor, OH 44060
Phone (440) 205-9910

Organizations & group practices 3

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7211 Ctr St
Mentor, OH 44060-4907
Phone (440) 205-9910

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1245375351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7257 CENTER ST",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604907",
            "telephone_number": "440-205-9910",
            "fax_number": "440-974-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7249 CENTER ST STE 2",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604907",
            "telephone_number": "440-205-9910",
            "fax_number": "440-974-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKED",
        "first_name": "MONDA",
        "middle_name": "T",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.