NPIMap

Individual provider Active NPI

Clifford A Monda, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Greenwood, SC
National Provider Identifier
1265458731
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
720 Issued in SC
Practice address
1530 Parkway
Greenwood, SC 29646-4027
Phone
(864) 330-1666
Fax
(864) 330-1870
NPI assigned
Jul 15, 2006
Last updated
Jul 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 720 SC Primary

Addresses

Primary practice location

1530 Parkway
Greenwood, SC 29646-4027

Mailing address

PO Box 50087
Greenwood, SC 29649-0019
Phone (864) 330-1666

Other identifiers 1

IdentifierTypeStateIssuer
T00406MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040914000752 SC Practitioner - Physical Medicine and Rehabilitation 4284601774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
West Virginia School of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Medical RehabilitationGroup PAC ID 9537233762, 2 clinicians

Practice addresses (Care Compare)

1530 Pkwy
Greenwood, SC 29646-4027
Phone (864) 330-1666

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vibra Physicians LLC CurrentSince Nov 1, 2020 Accepting new patients
Palmetto Medical Rehabilitation Physical Medicine & Rehabilitation CurrentSince Aug 5, 2008 Accepting new patients

Locations

1530 Parkway
Greenwood, SC 29646
Phone (864) 330-1666

1200 Hospital Dr
Mt Pleasant, SC 29464
Phone (843) 226-7721

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Greenwood Transitional Rehabilitation UnitGreenwood, SC, CCN 425388 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 7, 2008
Jul 7, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 9

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1265458731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50087",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490019",
            "telephone_number": "864-330-1666",
            "fax_number": "864-330-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PARKWAY",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464027",
            "telephone_number": "864-330-1666",
            "fax_number": "864-330-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDA",
        "first_name": "CLIFFORD",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T00406",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.