Individual provider Active NPI

Brandon Thomas Mondor, DC

  • Chiropractor
  • Hudson, WI
National Provider Identifier
1689441941
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6144-12 Issued in WI
Practice address
131 Carmichael Rd
Hudson, WI 54016-8269
Phone
(715) 386-7690
NPI assigned
Dec 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6144-12 WI Primary

Addresses

Primary practice location

131 Carmichael Rd
Hudson, WI 54016-8269

Mailing address

754 190TH Ave
Somerset, WI 54025-7405
Phone (715) 808-4553

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110000511 WI Practitioner - Chiropractic 9335590777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McCabe Chiropractic and Wellness Center IncGroup PAC ID 9234227570, 3 clinicians

Practice addresses (Care Compare)

131 Carmichael Rd
Suite 202
Hudson, WI 54016-8271
Phone (715) 386-7690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6144-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
McCabe Chiropractic and Wellness Center Inc Chiropractor CurrentSince Dec 13, 2023 Accepting new patients
Olien Family Chiropractic LLC Chiropractor PastSince Sep 2, 2003 Accepting new patients
Daulton Physical Therapy, LLC PastSince Dec 13, 2023 Accepting new patients

Locations

131 Carmichael Rd
Ste 202
Hudson, WI 54016
Phone (715) 386-7690

706 W 4th St
New Richmond, WI 54017
Phone (715) 246-2390

706 W 4th St
Ste 202
New Richmond, WI 54017

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.

NPI Registry JSON

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1689441941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 190TH AVE",
            "city": "SOMERSET",
            "state": "WI",
            "postal_code": "540257405",
            "telephone_number": "715-808-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CARMICHAEL RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168269",
            "telephone_number": "715-386-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDOR",
        "first_name": "BRANDON",
        "middle_name": "THOMAS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6144-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.