JONATHAN M MONGOLD (D.O.) – Family Medicine Physician, NPI 1205179553
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,052 FAMILY PRACTICE in IL
Provider Addresses for JONATHAN M MONGOLD (D.O.)
2160 S 1st Ave
Loyola Outpatient Center, 4300
Maywood, IL 601533328
Phone: (708) 216-6006
Fax: (708) 216-2683
Type: Location
2160 S 1ST AVE
LOYOLA OUTPATIENT CENTER, 4300
MAYWOOD, IL 601533328
Phone: (708) 216-6006
Fax: (708) 216-2683
Type: Mailing
1200 W WHITE RIVER BLVD # 4300
MUNCIE, IN 473034988
Phone: (877) 668-5621
Type: Mailing
5177 MCCARTY LN
LAFAYETTE, IN 479058764
Phone: (765) 448-8000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-08-30
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170830000402 | I | Family Practice | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 385 | 173 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 324 | 49 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 324 | 49 | $0 |
| 98929 | Osteopathic manipulative treatment, 9-10 body regions | 63 | 14 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 42 | 27 | $0 |
Insurance plans in this area (ZIP 60153)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| - | IN | |
| - | KY | |
| Internal Medicine | IL | |
| Cardiovascular Disease (Cardiology) | CA | |
| Internal Medicine | IN | |
| Internal Medicine, Hospitalist | IN | |
| Diagnostic Radiology, Interventional Radiology | IN | |
| Interventional Radiology | IN | |
| Nurse Practitioner | IN |
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