NPIMap

Individual provider Active NPI

Olga Mondrusova, MD

  • Family Medicine Physician
  • Novi, MI
National Provider Identifier
1689638330
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301071758 Issued in MI
Practice address
40015 Grand River Ave
Suite 100
Novi, MI 48375-2160
Phone
(248) 473-8580
Fax
(248) 474-4208
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301071758 MI Primary

Addresses

Primary practice location

40015 Grand River Ave
Suite 100
Novi, MI 48375-2160

Mailing address

40015 Grand River Ave
Suite 100
Novi, MI 48375-2160
Phone (248) 473-8580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101117000520 MI Practitioner - Family Practice 3577758408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Robert K. Brateman MD PCGroup PAC ID 4486703428, 2 clinicians

Practice addresses (Care Compare)

40015 Grand River Ave
Novi, MI 48375-2160
Phone (248) 473-8580

Hospital & facility affiliations

  • Tone Home Health Services Home health agency, Farmington Hills, MI, CCN 237634
  • Residential Home Health Home health agency, Troy, MI, CCN 237459
  • Henry Ford Home Health Care Home health agency, Detroit, MI, CCN 237087
  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

Merit-based Incentive Payment System (MIPS)

Final score
83.68 of 100Reported as group
Quality
91.56
Promoting interoperability
85
Improvement activities
40
Cost
66.53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301071758MIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: olga.mondrusova.p1@direct.rbrateman.nextgenshare.com
  • Direct secure messaging: omondrusova1141921@direct.hfhs.org

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286841600000",
    "number": "1689638330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40015 GRAND RIVER AVE",
            "address_2": "SUITE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752160",
            "telephone_number": "248-473-8580",
            "fax_number": "248-474-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40015 GRAND RIVER AVE",
            "address_2": "SUITE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752160",
            "telephone_number": "248-473-8580",
            "fax_number": "248-474-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDRUSOVA",
        "first_name": "OLGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2010-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301071758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.