Lucinda L Mundorf, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0062705 Issued in MD

Practice address

709 4TH Ave NE
Waterford City, ND 58854-7628

Phone

(701) 842-3771

Fax

(701) 444-4025

NPI assigned

Dec 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, ND2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• McKenzie County Healthcare Systems Inc

  • Urgent Care Clinic/Center
  • Williston, ND
  • NPI 1396516506
  Medicare reassignment NPD
• TCMG PA

  • Internal Medicine Physician
  • Parkville, MD
  • NPI 1912030073
  Medicare reassignment NPD
• McKenzie County Healthcare Systems Inc

  • Critical Access Hospital
  • Watford City, ND
  • NPI 1518988948

  Internal Medicine

  NPD
• McKenzie County Healthcare Systems Inc

  • Rural Health Clinic/Center
  • Watford City, ND
  • NPI 1457374217
  NPD (past)
• Cogent Healthcare of Jackson Ms, LLC

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1699726836
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Magnolia Internal Medicine Clinic

  • Internal Medicine Physician
  • Corinth, MS
  • NPI 1316106255
  NPD (past)
• Titus C. Abraham, MD, LLC

  • Internal Medicine Physician
  • Annapolis, MD
  • NPI 1407295967
  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1497732374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 4TH AVE NE",
            "city": "WATERFORD CITY",
            "state": "ND",
            "postal_code": "588547628",
            "telephone_number": "701-842-3771",
            "fax_number": "701-444-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 4TH AVE NE",
            "city": "WATERFORD CITY",
            "state": "ND",
            "postal_code": "588547628",
            "telephone_number": "701-842-3771",
            "fax_number": "701-444-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDORF",
        "first_name": "LUCINDA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "17890",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0062705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.