NICKOLAS MUNDO
NPI 1528754884
Family Medicine in Fort Worth, TX
About Nickolas Mundo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICKOLAS MUNDO (NPI 1528754884) is an individual family medicine provider in Fort Worth, Texas, licensed in Texas (V3055) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, is affiliated with Faith Community Hospital, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Nickolas Mundo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Nickolas Mundo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lubbock, TX 79401
- Reassigned Medicare billing, Texas enrollment
- 1,338 clinicians in this Medicare group
Lubbock, TX 79401
- Reassigned Medicare billing, Texas enrollment
- 1,439 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Faith Community Hospital
Acute Care Hospitals · Jacksboro, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
FORT WORTH, TX 76104
FORT WORTH, TX 76104
FORT WORTH, TX 76104
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Nickolas Mundo's NPI number?
The NPI number for Nickolas Mundo is 1528754884. It was assigned to this individual provider in the NPPES registry on April 11, 2023.
Where is Nickolas Mundo located?
Nickolas Mundo practices at 1500 S Main St, Fort Worth, TX 76104. The listed phone number is (817) 702-1100.
What is Nickolas Mundo's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Nickolas Mundo enrolled in Medicare?
Yes. Nickolas Mundo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Nickolas Mundo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nickolas Mundo reassigns Medicare benefits to 2 organizations: Concord Medical Group PLLC (Lubbock, TX) and Concord Medical Group Of Texas PLLC (Lubbock, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nickolas Mundo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nickolas Mundo accept?
Health plans from Blue Cross and Blue Shield of Texas list Nickolas Mundo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Nickolas Mundo affiliated with any hospitals?
According to CMS data, Nickolas Mundo is affiliated with Faith Community Hospital.
When was this NPI record last updated?
The NPPES record for Nickolas Mundo was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Nickolas Mundo · NPI 1528754884
Family Medicine physician in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since April 11, 2023.
## Identity
- **NPI:** 1528754884 (Entity type: Individual)
- **Enumerated:** April 11, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** V3055 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 1500 S MAIN ST, Fort Worth, TX 76104-4917
- **Phone:** (817) 702-1100
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Concord Medical Group PLLC (NPI 1083630610, Lubbock, TX); Concord Medical Group Of Texas PLLC (NPI 1750790762, Lubbock, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** July 16, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1528754884) · Data from the CMS NPPES public registry.