Individual provider Active NPI

Pratik Mondal

  • Cardiovascular Disease Physician
  • Kingston, NY
National Provider Identifier
1255735981
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
312076 Issued in NY
Practice address
111 Marys Ave Ste 3
Kingston, NY 12401-5896
Phone
(845) 339-3663
Fax
(845) 339-3629
NPI assigned
Oct 9, 2014
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 312076 NY Primary

Addresses

Primary practice location

111 Marys Ave Ste 3
Kingston, NY 12401-5896

Mailing address

19 Bradhurst Ave Ste 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pratik.mondal@wmchealth.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210805000514 NY Practitioner - Internal MedicinePractitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9234533712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology), Interventional Cardiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Foxhall Ave
Kingston, NY 12401-5107
Phone (845) 338-1535

105 Marys Ave
Kingston, NY 12401-5829
Phone (845) 331-3131

111 Marys Ave
Suite 3
Kingston, NY 12401-5896
Phone (845) 339-3663

117 Marys Ave
Suite 102
Kingston, NY 12401-5849
Phone (845) 338-5555

396 Broadway
Kingston, NY 12401-4626
Phone (845) 331-3131

42082 State Hwy 28
Suite 17
Margaretville, NY 12455-2820
Phone (845) 303-1132

42084 State Hwy 28
Margaretville, NY 12455-2820
Phone (845) 586-2631

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
312076NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Aug 1, 2021 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Aug 1, 2021 Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

111 Marys Ave
Ste 3
Kingston, NY 12401
Phone (845) 452-7319

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

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

Hospital & facility affiliations 5

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": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1255735981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARYS AVE STE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015896",
            "telephone_number": "845-339-3663",
            "fax_number": "845-339-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDAL",
        "first_name": "PRATIK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-09",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "312076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pratik.mondal@wmchealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "111 Marys Ave Ste 3",
            "city": "Kingston",
            "state": "NY",
            "country_code": "US",
            "postal_code": "124015896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.