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NICHOLAS MONDORE PA-C
NPI 1639041023
Physician Assistant - Surgical in Albany, NY

Active since September 23, 2025PECOS EnrolledAccepts Medicare Assignment
1367 WASHINGTON AVE STE 200, ALBANY, NY 12206(518) 489-2666 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Nicholas Mondore Pa-c NPPES

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

NICHOLAS MONDORE PA-C (NPI 1639041023) is an individual surgical provider in Albany, New York and active in the NPI registry since September 2025. He is enrolled in Medicare PECOS and is a graduate of State University Of Ny Upstate Medical University (2025).

NPPES Registry Identity

NPI1639041023
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameNICHOLAS MONDORECredential: PA-C
Location Address1367 WASHINGTON AVE STE 200Albany, NY 12206-1043
Mailing Address1703 Forest Ridge BlvdSaratoga Springs, NY 12866-7432 · (315) 939-9943
Phone(518) 489-2666
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2025
Enumeration DateSeptember 23, 2025
NPPES CertifiedSeptember 23, 2025
✔ NPI 1639041023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
1367 WASHINGTON AVE STE 200, Albany, NY 12206
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicholas Mondore Pa-c 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.

PECOS PAC ID3476029372
PECOS Enrollment IDI20260417002506
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.

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.

GEORGE S ZANAROS M.D.
Orthopaedic Surgery (Hand Surgery)
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 489-2666
SEAN WILLIAM LEAHY PA-C
Physician Assistant
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 489-2999
BRIAN SICKE NP
Nurse Practitioner (Family)
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 489-2666
DR. DIONISIO ORTIZ III MD
Orthopaedic Surgery
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 489-2666
JOACHIM J TENUTA M.D.
Orthopaedic Surgery
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 292-2632
CAROLYN D LANNE FNP
Nurse Practitioner (Family)
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 489-2632
MICHAEL MULLIGAN
Orthopaedic Surgery (Hand Surgery)
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 489-2666
DR. ROBERT O'LEARY
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
1367 WASHINGTON AVE STE 200
ALBANY, NY 12206
Albany County (518) 489-2666

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 Nicholas Mondore's NPI number?

The NPI number for Nicholas Mondore is 1639041023. It was assigned to this individual provider in the NPPES registry on September 23, 2025.

Where is Nicholas Mondore located?

Nicholas Mondore practices at 1367 Washington Ave Ste 200, Albany, NY 12206. The listed phone number is (518) 489-2666.

What is Nicholas Mondore's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Nicholas Mondore enrolled in Medicare?

Yes. Nicholas Mondore 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.

When was this NPI record last updated?

The NPPES record for Nicholas Mondore was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.