Individual provider Active NPI

Michael A Mundell, M.D.

  • Anesthesiology Physician
  • Santa Rosa, CA
National Provider Identifier
1790709392
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G28146 Issued in CA
Practice address
3325 Chanate Rd
Santa Rosa, CA 95404-1707
Phone
(707) 576-4000
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G28146 CA Primary

Addresses

Primary practice location

3325 Chanate Rd
Santa Rosa, CA 95404-1707

Mailing address

3325 Chanate Rd
Santa Rosa, CA 95404-1707
Phone (707) 576-4000

Other identifiers 1

IdentifierTypeStateIssuer
00G281461MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: mmundell208899@hisp.ehr.sutterhealth.org

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1790709392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "707-576-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "707-576-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDELL",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G28146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G281461",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.