Individual provider Active NPI

Elizabeth Mary Mongold, OTR

  • Occupational Therapist
  • Austin, TX
National Provider Identifier
1609598879
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
122859 Issued in TX
Practice address
1102 S Congress Ave
Austin, TX 78704-1728
Phone
(512) 462-5350
Fax
(521) 462-5359
NPI assigned
Sep 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 122859 TX Primary

Addresses

Primary practice location

1102 S Congress Ave
Austin, TX 78704-1728

Mailing address

1102 S Congress Ave
Austin, TX 78704-1791
Phone (512) 462-5350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
122859TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas School for the Deaf PastSince Dec 18, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1609598879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 S CONGRESS AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787041791",
            "telephone_number": "512-462-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S CONGRESS AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787041728",
            "telephone_number": "512-462-5350",
            "fax_number": "521-462-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGOLD",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "122859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.