Albert Joseph Mungo, MD
Individual provider Active NPI Diagnostic Radiology Physician · Halifax, VA
NPI 1972689883 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972689883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 0101235169 (VA)
- Practice address
- 2204 Wilborn Avenue
Halifax Regional Hospital
Halifax, VA 24592 - Phone
- (434) 517-3187
- Fax
- (434) 517-3686
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Foundation Radiology Group PC
Practice addresses (Care Compare)
1755 N Mecklenburg Ave
South Hill, VA 23970-4080
Phone (412) 230-8200
Hospital & facility affiliations
- Community Memorial Hospital
- Medical College of Virginia Hospitals
- Bon Secours Southern Virginia Medical Center
- Sentara Halifax Regional Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040527000571 | VA | Practitioner - Diagnostic Radiology | 2163403973 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation Radiology Group PC | Diagnostic Radiology | Current |
Accepting new patients |
| Halifax Radiological Associates, Inc. | Diagnostic Radiology | Past | Accepting new patients |
Locations
75 Remittance Dr
#8310
Chicago, IL 60675
Phone (317) 805-4034
1755 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 584-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0101235169 | VA | Yes |
Addresses
Primary practice location
2204 Wilborn Avenue
Halifax Regional Hospital
Halifax, VA 24592
Mailing address
PO Box 340
Halifax, VA 24558
Phone (434) 575-1683
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002596 | Other | BC |
Other providers in Halifax, VA
- Marsha'S Home Care Agency
- Amanda Rogers McDowell
- Roy McKinnis
- Mental Swellness
- Francis Barnes Mitchell
- Pathways Youth Services LLC
- Patient Transport Systems, Inc
- Gabrielle Pecoraro
- Rural Podiatry, LLC
- Shannon N Scearce
All providers in Halifax, VA · Diagnostic Radiology Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.