Freeborn Mondello

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12654 Issued in CO

Practice address

20 Meadow Hawk LN
Silver City, NM 88022-9727

Phone

(541) 951-8170

NPI assigned

Sep 23, 2014

Last updated

Sep 23, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Runfreept

  • Physical Therapy Clinic/Center
  • Silver City, NM
  • NPI 1851700058
  NPD (past) Authorized official
• Runfree, LLC

  • Physical Therapist
  • Golden, CO
  • NPI 1861971392
  Authorized official Same address or phone

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1790187631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEADOW HAWK LN",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880229727",
            "telephone_number": "541-951-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEADOW HAWK LN",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880229727",
            "telephone_number": "541-951-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDELLO",
        "first_name": "FREEBORN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "12654",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4487",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21351",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindcare Solutions of New Mexico, P.C.
• Michelle S. Mittica, ABOC
• Nicholas M. Mittica Jr., M.D.
• Moncure Health and Wellness
• Shannon Marie Moncure, APRN, FNP-C
• Meya Mongkuo
• Lucy M Montoya, R.N.
• Meagan Montoya, DNP, FNP-BC
• Susan Montoya
• Marrissa M Moore, BSW

• Physical Therapist in Silver City, NM
• Providers in Silver City, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.