NICOLE ROSE MUNDACKAL MD
NPI 1043898992
Pediatrics in Sacramento, CA

Q: What is Nicole Mundackal's NPI number?

The NPI number for Nicole Mundackal is 1043898992. It was assigned to this individual provider in the NPPES registry on March 31, 2021.

Q: What is Nicole Mundackal's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Mundackal was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 31, 2021PECOS Enrolled

6600 BRUCEVILLE RD, SACRAMENTO, CA 95823(916) 688-6800(631) 444-2894 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 11, 2024, Mar 31, 2021 (2 updates tracked since 2021).

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About Nicole Rose Mundackal Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE ROSE MUNDACKAL MD (NPI 1043898992) is an individual pediatrics provider in Sacramento, California, licensed in California (A199410) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043898992

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameNICOLE ROSE MUNDACKALCredential: MD

Location Address6600 BRUCEVILLE RDSacramento, CA 95823-4671

Mailing Address6600 Bruceville RdSacramento, CA 95823-4671 · (916) 688-6800

Phone(916) 688-6800

Fax(631) 444-2894

Sole ProprietorNo

Enumeration DateMarch 31, 2021

Last NPPES UpdateNovember 11, 20242 updates tracked since enumeration

NPPES CertifiedNovember 11, 2024

✔ NPI 1043898992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · A199410

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

6600 BRUCEVILLE RD, Sacramento, CA 95823

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Rose Mundackal Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nicole Mundackal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

32 mi

Internal Medicine

7373 WEST LANE
Stockton, CA 95210

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95823 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.61 typical visit price

range $60.44 – $180.85

Typical copayment $23.15 (range $15.11 – $45.21)

Most-billed visit code 99203

Established Patient

$105.95 typical visit price

range $19.88 – $148.15

Typical copayment $26.48 (range $4.97 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON KENTERA CRNA

Nurse Anesthetist, Certified Registered